Breast Cancer and Precursor Lesions

Karima Idrissi, Hinde Elfatemi, khadija Benhayoun, Hfid Imane, Laila Chbani, Taoufik Harmouch, Afaf Amarti


Precursor lesions of the breast involved in the development of some pure forms of special types of low grade breast carcinoma in-situ and invasive carcinomas. This study was undertaken to determine the morphologic features and frequency of these lesions to suggest that they represent a family members of low grade precursor for in-situ and invasive neoplastic lesions of the breast.
We reviewed 186 cases of breast cancer diagnosed on January 2010 to April 2011 at the Department of Pathology, Hassan II teaching hospital, Fez, Morocco. Columnar cell lesions (CCLs), usual epithelial hyperplasia, ductal carcinoma in- situ (DCIS), and lobular neoplasia (LN) was determined. Histological grading and immunohistochemical profile were studied. The epidemiological statistics were carried out using Epi-Info (version 3.5.4).
Ductal carcinoma in-situ (DCIS) was determined in 41%, columnar cell lesions (CCLs) in 18%, usual epithelial hyperplasia in 6%, lobular neoplasia (LN) in 3%, adenosis (3%) and fibrocystic mastopathy (2%). Some lesions were not observed with the lobular carcinoma like usual epithelial hyperplasia and adenosis. The histological grade distribution for precursor lesion were grade I in 64% followed by grade II in 26% and grade III in 20% (p<0.0005). Luminal A subtype was associated with pre-invasive lesion in 62%, followed by luminal B subtype (41%), Her 2-overexpressing (46%) and basal-like subtype (34%). In this study we cannot demonstrate the significant association between usual epithelial hyperplasia and the molecular subtype, neither between molecular subtype and columnar cell lesions.
We have shown that epithelial atypia maybe intermediate state but not obligatory for some invasive breast cancer, a number of them can influence the molecular subtype.

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