Clinicopathological Study of Breast Lesions with Special Reference to the Role of CD34 Immunostaining in DiagnosisA Cross-sectional Study from a Tertiary Care Hospital of West Bengal, India

Abstract

Introduction: Breast carcinoma is the most common cancer among women and leading cause of mortality. Prognosis of breast carcinoma primarily depends on early detection. The changes in molecular and antigenic expression in stromal microenvironment surrounding the tumour cells was noted earlier in tumours of skin and gastrointestinal tract which showed loss of Cluster of Differentiation 34 (CD34) expression in stromal cell of malignant tumours. Aim: To evaluate the intensity of CD34 staining in benign, borderline and malignant lesions of breast and to find out whether it can help to differentiate benign and malignant lesions from borderline and in situ carcinomas. Materials and Methods: This was a cross-sectional prospective study done over a period of 18 months in a tertiary care hospital of Bankura, West Bengal, India. Total 78 specimens of breast lesions obtained by lumpectomy and Modified Radical Mastectomy (MRM) were first evaluated on routine histology and classified as benign, borderline or malignant accordingly. Subsequent immunohistochemical staining was performed for CD34 and intensity of expression in stromal cells was graded from 0 to 3+. Then comparison of CD34 expression in different lesions was done and level of significance was assessed by using Student’s t-test. Results: Out of total 78 cases evaluated, 50 (64.1%) were categorised as benign and rest 28 (35.9%) were either premalignant or malignant lesions. Intensity of CD34 expression was found to be significantly higher in benign and in situ lesions compared to malignant epithelial lesions of breast (p<0.05) whereas those between borderline and malignant phyllodes found to be statistically non significant (p-value 0.342). Conclusion: CD34 immunostaining can help to differentiate benign and in situ carcinomas from invasive carcinomas, however its role in differentiating borderline from malignant phyllodes tumour is limited.