Cystosarcoma phyllodes of the breast: prognostic significance of proliferation and apoptosis associated genes.

BACKGROUND

Cystosarcoma phyllodes (CP) is a rare fibroepithelial tumor of the breast. So far no valuable prognostic factors are available for predicting the biological behaviour and often unexpected clinical outcome of this tumor.

PATIENTS AND METHODS

Using immuno-histochemistry, Mib-1 evaluated proliferative activity and expression of p53, Bcl-2, c-erbB1, c-erbB2, cytokeratin and vimentin were analysed in 17 benign and 12 malignant CP.

RESULTS

Cell proliferation was significantly higher in malignant tumors compared to benign ones both in the epithelial and mesenchymal parts. In the epithelial part Bcl-2 positive cells were found more frequently in benign than in malignant lesions. Positive immunoreactivity for p53 was seen in only one malignant case. The reaction was positive in the both epithelial and mesenchymal compartments. Expression of c-erbB-proteins was not found in any case. The intermediate filament proteins indicate clearly the two components of the tumor.

CONCLUSIONS

We concluded that increased proliferate activity and downregulation of Bcl-2 may be associated with dedifferentiation of cells and malignant progression. C-erbB-proteins are obviously not involved in carcinogenesis of CP.