Original Article
Mod Pathol 2002;15(1):18–25
Quantitative Study of Breast Cancer Progression: Different Pathways for Various In Situ Cancers
L Mariuzzi M.D.1, A Mombello M.D.2, G Granchelli M.D.2, V Rucco M.D.2, E Tarocco M.D.2, D Frank Ph.D.4, J Davis M.D.3, D Thompson M.Sc.5, H Bartels M.SIE.5, G M Mariuzzi M.D.2 and P H Bartels Ph.D., F.I.A.C.(Hon), M.D. (Hon)5
- 1Departments of Pathology of the University of Udine, Verona, Italy
- 2University of Verona, Verona, Italy
- 3Department of Pathology, University of Arizona, Tucson, Arizona
- 4Arizona Cancer Center, University of Arizona, Tucson, Arizona
- 5Optical Sciences Center, University of Arizona, Tucson, Arizona
Correspondence: Gian M. Mariuzzi, M.D., Dipartimento di Patologia-Sezione di Anatomia Patologica, Policlinico G.B. Rossi, Via delle Menegone, 10, Verona, 37134 Italy. e-mail: g.mariuzzi@univr.it; fax: 39-045-802 7136.
Accepted 9 October 2001.
Abstract
The chromatin pattern in nuclei from breast ductal proliferative lesions was quantitatively evaluated with the objective of deriving measures of tumor progression. A total of 110 cases were analyzed. There were 38 cases of normal tissue or benign proliferative lesions, 41 cases of ductal carcinoma in situ (DCIS), and 31 cases of microinfiltrating DCIS and of infiltrating cancer. A total of 9424 nuclei were analyzed. High-resolution images were digitally recorded. For each nucleus, 93 karyometric features descriptive of the spatial and statistical distribution of the nuclear chromatin were computed. Data analysis included establishing a profile of relative deviations of each feature from "normal," called the nuclear signature, and of lesion signatures as well as of trends of lesion progression. Two trends of evolution could be discerned: one from normal to hyperplasia, atypical hyperplasia, and comedo DCIS as representative of high-grade lesions; and the other from normal to hyperplasia to cribriform DCIS, solid DCIS, and infiltrating cancer, representing lower grade lesions. The nuclei in microinfiltrating foci are distinctly different from nuclei in high-grade comedo DCIS. The nuclei in microinfiltrating foci have a statistically significantly lower nuclear abnormality. They may represent outgrowing clones.
Keywords:
DCIS, Grading, Nuclear and lesion signature, Pathway of evolutionary change, Prognosis, Quantitative analysis

