Upgraded Malignancy from High-Risk and Borderline Breast Lesions: Immunohistochemical and Clinical Characteristics

Abstract

Purpose: The purpose of this study was to investigate the immune-histochemical characteristics of upgraded malignancy from high-risk and borderline breast lesions, and to correlate the upgrade rates with clinical findings. Materials and Methods: We scrutinized image-guided biopsy records retrospectively, and included all women afflicted with high-risk and borderline breast lesions during the period, 2011 to 2015, inclusive. A total of 340 high-risk and borderline lesions were identified by the pathologist in biopsy samples and thereafter, surgical excision and/or image follow-up for at least 24 months was performed. We compared the clinical emanating from both high-risk and borderline lesions, and with and without cancer upgrade. In the instances of lesions with cancer upgrade, histologic and immuohistochemical reviews were performed. Results: Of the 340 high-risk or borderline lesions, 18.8% (64/340) were upgraded. The upgrade rates were higher in patients of more advanced age, larger body habitus and afflicted with atypical ductal hyperplasia rather than with other pathology (p < 0.05). In the lesions with cancer upgrade (n = 64), there was no lymph node metastasis. The estrogen receptor-positive (93.8%), progesterone receptor-positive (87.5%), human epidermal growth factor receptor type 2-negative (90.6%), Ki-67-negative (82.8%), and Luminal A (76.6%) types were seen more frequently. Conclusion: Most upgraded malignancies arising from high-risk and borderline breast lesions were found to be Luminal A-type with good prognostic factors, and the upgrade rates correlated with clinical characteristics.

Keywords

• image-guided biopsy
• breast neoplasm
• atypical ductal hyperplasia
• immunohistochemistry