[Frequency distribution, microscopic image analysis and grading of mammary carcinoma]

Abstract

The frequency of diagnoses of breast diseases in 1685 patients was examined on the basis of biopsy material at the Institute of Pathology of Charité Hospital in Berlin, during 1984-1987, with particular consideration of histological types of mammary carcinomas. Breast cancer was detected in 562 patients of whom 429 had undergone operations according to standardized recommendations by the Charité Department of Surgery. Histological tumor classification, postoperative staging and, in cases of invasive ductal carcinoma, also histological grading were part of the pathologico-anatomic investigation. Reproducibility of grading was 72.7% for intra-observer examination and 63.3% for evaluation by different pathologists. A group of 20 premenopausal patients with tumors staged as pT1, pN0 was selected for morphometric studies and objectivation of tumor grading. HE-stained paraffin sections were made for conventional grading according to Bloom and Richardson (1957), whereas Feulgen reaction in 4 microns thick sections was used for quantitative examination by means of a microscopic image analysis system (Robotron A6471 with AMBA/R software). The measuring program used was based mainly on evaluation of karyometric features. Measurements were concentrated on analysis of the chromatin structure of tumor cell nuclei. Correlations with histological grading were found to exist for 16 features out of 28 parameters selected for statistical analysis. Some new parameters of the texture of tumor cells nuclei were demonstrated to be strongly correlated with the degree of tumor differentiation. The prognostic significance of nuclear texture features has to be proved by further studies in which clinical data of the course of the tumor disease must be included.