Abstract:
The aim of our study was to develop new criteria for the differential diagnosis of variants of intraepithelial neoplasia of the mammary gland accessory lobe based on the use of a comprehensive morphological method of investigation using an optimal panel of markers to improve the quality of diagnosis and assessment of invasive cancer risk. Background.
Along with breast cancer, the number of cases of the mammary gland accessory lobe cancer has increased in recent years. This trend requires careful screening among women from the high-risk group, which include, first of all, patients with precancerous lesions of the breast. The method of immunohistochemistry in recent years has become widely used by researchers in the study of intraepithelial neoplasia of the breast and its lobe with the aim of early diagnosis and prognosis. Material and methods. The study was based on the results of a retrospective examination of 182 patients with mammary gland accessory lobe cancer. According to the morphological examination results, the patients were divided into 4 groups. The intensity of reactions localized in the cytoplasm and on cell membranes was evaluated by a semi-quantitative method on a point scale from O to 3 using the Leica Q550 image analyzer. Results. In 31 (50.0%) cases of dysplasia the process was
located in the right breast, in 27 (43.6%) women - in the left breast, and in 4 (6.4%) cases the lesion was bilateral. There were no significant differences in the location of the pathological process in invasive ductal carcinoma. At invasive lobular carcinoma in situ in 12 (42.9%) cases the pathological process was located on the left, and in 16 (57.1%) cases – on the right. Conclusion. Thus, the expression of cytokeratins 5/6 and 14 types is significantly more often observed in dysplasia (p= 0.0005), which allows them to be used for additional differential diagnosis of dysplasia and highly differentiated carcinomas in situ. Determination of the levels of cytokeratins 5/6, H, cyclin D1, E-cadherin and 3-catenin is the most important tool for the differential diagnosis of various types of breast neoplasia and its additional lobes as an independent factor in assessing tumor invasiveness.
