AN ASSESSMENT OF ELASTOSIS IN FIBROCYSTIC BREAST DISEASE AND INVASIVE BREAST CARCINOMA

Fibrocystic disease is one of the most common benign condition of the breast. Its incidence is significantly increased by nulliparity, late age of first birth, and late menopause, factors also associated with increased risk for breast carcinoma risk. Breast cancer is the second leading cause of cancer related deaths in females all over the world. Materials and methods : In the present study 30 cases of fibrocystic disease and carcinoma breast were taken and studied for the presence and grade of elastosis using Hematoxylin Eosin staining and Verhoeff Van Gieson staining. Results : The association between ductal epithelial hyperplasia and grade of elastosis in the Fibrocystic breast disease increased with the severity of the epithelial hyperplasia, but was not statistically significant . The correlation between histological grade of invasive ductal carcinoma-NOS type and grade of elastosis was statistically insignificant, but may be used as predictive marker of response to endocrine therapy.

Fibrocystic disease is one of the most common benign condition of the breast. Its incidence is significantly increased by nulliparity, late age of first birth, and late menopause, factors also associated with increased risk for breast carcinoma risk. Breast cancer is the second leading cause of cancer related deaths in females all over the world. Materials and methods : In the present study 30 cases of fibrocystic disease and carcinoma breast were taken and studied for the presence and grade of elastosis using Hematoxylin Eosin staining and Verhoeff Van Gieson staining. Results : The association between ductal epithelial hyperplasia and grade of elastosis in the Fibrocystic breast disease increased with the severity of the epithelial hyperplasia, but was not statistically significant . The correlation between histological grade of invasive ductal carcinoma-NOS type and grade of elastosis was statistically insignificant, but may be used as predictive marker of response to endocrine therapy.

…………………………………………………………………………………………………….... Introduction:-
Fibrocystic disease is one of the most common benign condition of the breast. Its incidence is significantly increased by nulliparity, late age of first birth, and late menopause 1 , factors also associated with increased risk for breast carcinoma . Ductal and lobular hyperplasia, cyst formation, adenosis and fibrosis are major morphologic changes of fibrocystic breast disease. Ductal hyperplasia is a frequent constituent of fibrocystic change that may be detected by mammography or as a palpable tumor. Moderate or florid hyperplasia without atypia and sclerosing adenosis both are at slightly increased risk of breast carcinoma. 5,7 Epithelial hyperplasia is a premalignant component of fibrocystic breast disease and shows higher degree of elastosis when compared to other morphologic changes of FCD 6 . Breast cancer is the second leading cause of cancer related deaths in females all over the world. It has doubled in India in the last two decades. The significance and pathogenesis of elastosis in breast carcinoma is unknown 2 . It is common in infiltrating ductal and lobular carcinomas of the breast.
The presence of elastosis or elastic tissue in the stroma of sections from breast carcinoma was first described by Cheatle and Cutler. Elastic tissue is probably produced by fibroblasts, smooth muscle cells or myofibroblasts, under the stimulation of the infiltrating cancer cells. Elastosis was located around carcinomatous tissue mammary neoplastic ducts , around veins and as scattered foci in the stroma. Yellow streaks and flecks may be apparent grossly and probably reflect the increased elastic tissue. In H&E stained sections, elastosis is seen as a homogenous material with a faintly visible fibrillar appearance 2 .In sections stained with the Verhoeff-Van Gieson method, it is seen as ISSN: 2320-5407 Int. J. Adv. Res. 10(03), 526-530 527 densely packed black colored elastin fibrils. Periductal and stromal elastosis are usually observed in invasive carcinoma of breast 2 . Tumors lacking elastosis have showed lower rate of response to endocrine therapy 4 . Grade of elastosis was followed according to the study by Curt Lundmark 2 Grade 0 -No elastosis Grade 1-Mild to moderate degree of elastosis Grade 2-Gross elastosis

Aims and Objectives:-
To correlate grade of elastosis with ductal epithelial hyperplasia in fibrocystic breast disease and to correlate grade of elastosis with histological grade of carcinoma in invasive duct carcinoma using Verhoff Van Gieson staining .

Materials and Methods:-
30 reported cases of fibrocystic disease and 30 reported cases of invasive ductal carcinoma breast were chosen , grossed and macroscopic features noted. The tissue was then processed , paraffin sections were cut at 4 to 5 μm thickness and stained using Hematoxylin & Eosin and Verhoeff Van Gieson stains.

Analysis of Elastosis In cases of Fibrocystic Breast Disease
Total of 30 cases were studied and the following observations were obtained In this study Elastosis is more commonly associated with epithelial hyperplasia, but was not statistically significant (p value >0.05)

Analysis Of Elastosis In Invasive Ductal Carcinoma-NOS Type
Total of 30 cases were studied and following results obtained

Conclusion:-
The association between ductal epithelial hyperplasia and grade of elastosis in Fibrocystic breast disease increased gradually with the severity of the epithelial hyperplasia.The correlation between histological grade of invasive ductal carcinoma-NOS type and grade of elastosis was statistically insignificant , but tumors lacking elastosis have showed lower rate of response to endocrine therapy. So, this might be useful as predictive marker of response to endocrine therapy.