The biological and prognostic significance of cell polarity and E-cadherin in grade I infiltrating ductal carcinoma of the breast

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Abstract
Grading of breast cancer based on the modified Scarff, Bloom, and Richardson system provides invaluable prognostic information. Recent evidence suggests that most tumours do not usually progress between grades and that groups of tumours within each grade are biologically distinct. This study has explored one potential aspect of biological tumour heterogeneity within grade by examining the relationship between cell polarity, the cell adhesion molecule E‐cadherin, a major effector of cell polarity, and outcome, in 149 grade I infiltrating ductal breast carcinomas. Polarity was evaluated by studying the degree to which three features of polarized epithelial cells—nuclear ordering, basal positioning of nuclei within cells, and apical snouting/blebbing—were present in these tumours. E‐cadherin expression was investigated using the antibody HECD‐1. A low degree of tubule formation was correlated with poor nuclear ordering ( p< 0·01). The three histological features—nuclear ordering, basal nuclei, and apical blebbing—were all correlated with each other (all p< 0·0001). Polarity measurements did not correlate with survival. E‐cadherin expression did not correlate with polarity and negative tumours were still able to form tubules. Surprisingly, strong E‐cadherin immunostaining correlated with poor survival, tumour size, and nodal status. On univariate parametric (Weibull) survival models, high E‐cadherin scores and tumour size were both significant predictors of survival in this group. Copyright © 1999 John Wiley & Sons, Ltd.