Mitotic figure counts are significantly overestimated in resection specimens of invasive breast carcinomas.

Details

Serval ID
serval:BIB_1D995F5060A3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Mitotic figure counts are significantly overestimated in resection specimens of invasive breast carcinomas.
Journal
Modern Pathology
Author(s)
Lehr H.A., Rochat C., Schaper C., Nobile A., Shanouda S., Vijgen S., Gauthier A., Obermann E., Leuba S., Schmidt M., Ruegg C.C., Delaloye J.F., Simiantonaki N., Schaefer S.C.
ISSN
1530-0285 (Electronic)
ISSN-L
0893-3952
Publication state
Published
Issued date
2013
Volume
26
Number
3
Pages
336-342
Language
english
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Abstract
Several authors have demonstrated an increased number of mitotic figures in breast cancer resection specimen when compared with biopsy material. This has been ascribed to a sampling artifact where biopsies are (i) either too small to allow formal mitotic figure counting or (ii) not necessarily taken form the proliferating tumor periphery. Herein, we propose a different explanation for this phenomenon. Biopsy and resection material of 52 invasive ductal carcinomas was studied. We counted mitotic figures in 10 representative high power fields and quantified MIB-1 immunohistochemistry by visual estimation, counting and image analysis. We found that mitotic figures were elevated by more than three-fold on average in resection specimen over biopsy material from the same tumors (20±6 vs 6±2 mitoses per 10 high power fields, P=0.008), and that this resulted in a relative diminution of post-metaphase figures (anaphase/telophase), which made up 7% of all mitotic figures in biopsies but only 3% in resection specimen (P<0.005). At the same time, the percentages of MIB-1 immunostained tumor cells among total tumor cells were comparable in biopsy and resection material, irrespective of the mode of MIB-1 quantification. Finally, we found no association between the size of the biopsy material and the relative increase of mitotic figures in resection specimen. We propose that the increase in mitotic figures in resection specimen and the significant shift towards metaphase figures is not due to a sampling artifact, but reflects ongoing cell cycle activity in the resected tumor tissue due to fixation delay. The dwindling energy supply will eventually arrest tumor cells in metaphase, where they are readily identified by the diagnostic pathologist. Taken together, we suggest that the rapidly fixed biopsy material better represents true tumor biology and should be privileged as predictive marker of putative response to cytotoxic chemotherapy.
Keywords
Biopsy, Breast Neoplasms/chemistry, Breast Neoplasms/pathology, Carcinoma, Ductal, Breast/chemistry, Carcinoma, Ductal, Breast/pathology, Cell Proliferation, Female, Humans, Immunohistochemistry, Ki-67 Antigen/analysis, Linear Models, Mastectomy, Mitosis, Mitotic Index, Neoplasm Grading, Neoplasm Invasiveness, Predictive Value of Tests, Reproducibility of Results, Time Factors, Tissue Fixation
Pubmed
Web of science
Open Access
Yes
Create date
10/01/2013 8:30
Last modification date
20/08/2019 12:53
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