Preoperative determination of DNA ploidy and hormone receptor status (ER and PgR) on cytologic material from breast cancer patients using image cytometry

Abstract

OBJECTIVE: FNAB of breast masses is a commonly performed diagnostic test. DNA ploidy, along with estrogen (ER) and progesterone (PgR) receptors, is becoming increasingly useful as a prognostic adjunct to conventional staging and histologic grading. These prognostic parameters could be assessed preoperatively by using FNAB material. STUDY DESIGN: Sixty-three breast cancer aspirates were assayed for DNA distribution patterns and hormone receptor status with the CAS 200 Image Analyzing System. Consequently, their relations with well-established conventional prognostic factors in breast carcinoma (tumor size, lymph node status and histological grade) were analyzed. RESULTS:The majority of the primary invasive breast carcinomas were aneuploid (43/63). Most of the aneuploid tumors had histogram type IV (31/43). The data showed that breast carcinomas in which the DNA amounts of the tumor cells were euploid (histograms of types I and I1) were characterized by high levels of ER and PgR, while aneuploid types (histograms of types III and IV) had low levels of ER and PgR. Of the aneuploid breast carcinomas, 86.1% (37/43) had lymph node involvement, while only 40% (8/20) of the euploid carcinomas had lymph node involvement. The majority of the aneuploid carcinomas were of ductal type (29/43), while most of the lobular carcinomas were euploid (9/20). CONCLUSION: Our results strongly indicate a correlation between nuclear DNA distribution patterns, hormone receptor levels and postsurgical factors of prognosis in primary breast carcinomas. By determining the DNA ploidy and hormone receptor status preoperatively, the planning of treatment options available to breast cancer patients could be improved.