Garimella V, Long E D, O'Kane S L, Drew P J, Cawkwell L
Cancer Biology Proteomics Group, Postgraduate Medical Institute, University of Hull, United Kingdom.
Acta Oncol. 2007;46(2):204-7. doi: 10.1080/02841860600897884.
Widespread acceptance of breast conserving surgery for early breast cancer has led to renewed interest in multifocality, which is seen in 13-63% of breast cancers. According to current guidelines, oestrogen/progesterone receptor status is assessed on the sample obtained at initial core biopsy or the main tumour focus in multifocal breast cancer (more than one distinct tumour focus in a quadrant). We assessed receptor status of individual foci in multifocal breast cancer. Mastectomy specimens for 18 cases of multifocal breast cancer were identified. Immunohistochemical staining for oestrogen and progesterone receptors was performed on all tumour foci. On histological examination 11 patients demonstrated two independent tumour foci, three demonstrated three foci and four demonstrated four foci. Minor differences in oestrogen receptor score were seen between foci (attributed to the subjective nature of the scoring system), which did not affect the overall positive/negative classification. Sixteen patients (88%) were oestrogen receptor-positive. Progesterone receptor staining showed more variability between foci in two patients but, since the tumours were oestrogen receptor-positive this would not have affected clinical decision-making. No major differences in oestrogen receptor status between multiple tumour foci in the same quadrant were found in this pilot study.
早期乳腺癌保乳手术的广泛接受引发了对多灶性的新关注，多灶性在13%至63%的乳腺癌中可见。根据当前指南，雌激素/孕激素受体状态在初次粗针活检获取的样本或多灶性乳腺癌（一个象限内有一个以上不同肿瘤灶）的主要肿瘤灶上进行评估。我们评估了多灶性乳腺癌中各个病灶的受体状态。确定了18例多灶性乳腺癌的乳房切除术标本。对所有肿瘤灶进行雌激素和孕激素受体的免疫组织化学染色。组织学检查显示，11例患者有两个独立肿瘤灶，3例有三个病灶，4例有四个病灶。病灶之间雌激素受体评分存在微小差异（归因于评分系统的主观性），但这并不影响总体阳性/阴性分类。16例患者（88%）雌激素受体呈阳性。孕激素受体染色显示，两名患者的病灶之间变异性更大，但由于肿瘤为雌激素受体阳性，这不会影响临床决策。在这项初步研究中，未发现同一象限内多个肿瘤灶之间雌激素受体状态存在重大差异。
