Morphometric studies in early stage breast ancer with an intraductal component using computerized image analysis

摘要

AbstractThe hypothesis that hypoxia may be present in the intraductal component associated with infiltrating breast cancer was tested by studying the morphology of the intraductal component with respect to expansion of the tumor‐filled breast ducts and intraductal necrosis. Of 52 consecutive patients with T1–2N0–1M0infiltrating ductal breast carcinoma, 10 had an extensive intraductal component (EIC), 27 had a limited intraductal component (LIC), and 15 had no intraductal component. The necrosis‐containing comedo‐ and cribriform‐predominant types of intraductal carcinoma were common (50) in the EIC group, but infrequent (19) in the LIC group. The frequency of intraductal necrosis increased with duct diameter. Seventy‐five percent of ducts with a radius exceeding the oxygen diffusion distance (>180 μm) contained necrosis compared with 33 of ducts below that size. The average duct diameter was significantly larger (404 μm;P= 0.0056) and intraductal necrosis was more common (61) in the EIC group than in the LIC group (263 μm; 33). All patients with local recurrence in the EIC group (20) had the comedo‐predominant pattern, with a high percentage (79) of necrotic ducts. The increasing frequency of intraductal necrosis with increasing duct size, particularly with radii of more than 180 μm, suggests that tumor cell hypoxia is present in the intraductal component. The larger duct size and higher frequency of necrosis in the EIC group suggest that hypoxia is more common in EIC than in LIC. ©