Alvarado CI, Rubio GV, Valencia CR

Language: Spanish
References: 10
Page: 155-159
PDF size: 405.08 Kb.

ABSTRACT

Background: Recent studies have described a strong association among lobular carcinoma in situ (LCIS), columnar cell lesions (CCL), and tubular carcinoma (TC). The Rosen triad, named in tribute to its first categorical description by the eponymous pathologist, is a morphological observation that may have important clinical and pathologic implications.
Objective: To evaluate the frequency of Rosen triad in our patient population.
Material and method: The archives of the Department of Pathology of a Mexican Oncology Hospital were retrospectively searched to identify cases of TC diagnosed from 1999 to 2007. Only excisional biopsies or mastectomies were included. The CCLs were classified into three different categories (CCL without hyperplasia, CCL with hyperplasia lacking atypia, and CCL with atypia). The presence of an associated ductal carcinoma in situ (DCIS) was also assessed. Sections from each case were evaluated by immunohistochemistry with hormonal receptors (ER, PR) and Her2/neu.
Results: We identified 105 patients with tubular carcinoma with a mean age at diagnosis of 55 yr, the mean tumor size was 1.5 cm. All patients presented with a radiographically detected mass. In 63 of 105 (60%) cases of TC, both LCIS and at least one type of CCL were identified. All elements of the triad coexisted within the same space. In the triad group, CCL with atypia were identified in 44 of 63 patients (70%), 22% (14/63) cases were associated with CCL with hyperplasia without atypia. DCIS was present in 26 of 63 (41%) triad cases. All three lesions (TC, CCL and LCIS) were ER positive, PR positive and Her2/neu negative. Our study of 105 patients shows that TC is often associated with CCL and LCIS (60% of cases).
Conclusions: These findings support the hypothesis that TC and LCIS have direct evolutionary links to CCL.

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