Brain Metastases from Breast Cancer Histologically Exhibit Solid Growth-Pattern with at Least Focal Comedonecrosis: A Histopathologic Study on a Monocentric Series of 30 Cases

Farina, J.; Angelico, G.; Vecchio, G.M.; Salvatorelli, L.; Magro, G.; Puzzo, L.; Palicelli, A.; Zanelli, M.; Altieri, R.; Certo, F.; Spadola, S.; Zizzo, M.; Barbagallo, G.M.V.; Caltabiano, R.; Broggi, G. Brain Metastases from Breast Cancer Histologically Exhibit Solid Growth Pattern with at Least Focal Comedonecrosis: A Histopathologic Study on a Monocentric Series of 30 Cases. Diagnostics 2023, 13, 3141. Farina, J.; Angelico, G.; Vecchio, G.M.; Salvatorelli, L.; Magro, G.; Puzzo, L.; Palicelli, A.; Zanelli, M.; Altieri, R.; Certo, F.; Spadola, S.; Zizzo, M.; Barbagallo, G.M.V.; Caltabiano, R.; Broggi, G. Brain Metastases from Breast Cancer Histologically Exhibit Solid Growth Pattern with at Least Focal Comedonecrosis: A Histopathologic Study on a Monocentric Series of 30 Cases. Diagnostics 2023, 13, 3141.

Abstract

Since there are no morphological clues capable of making a pathologist suspect a possible mammary origin of a metastatic lesion without adequate clinical information, the histologic diagnosis of brain metastasis from BC is still based on the immunohistochemical expression of mammary gland markers such as GATA-3, ERs, PgRs and HER-2. The present retrospective study aimed to select purely morphological features capable to suggest the mammary origin of a metastatic carcinoma to the brain. The following histological features were collected on a series of 30 cases of brain metastases from breast cancer:(i) solid growth pattern; (ii) presence of comedonecrosis; (iii) glandular differentiation. Our results showed that most cases histologically exhibited solid growth pattern with at least focal comedonecrosis, producing an overall morphology closely reminiscent of mammary high-grade ductal carcinoma in situ. Although the above-mentioned morphological parameters are not strictly specific to a mammary origin, they may have an important diagnostic utility in leading pathologists to suspect a possible breast primary tumor and to include GATA-3, ERs, PgRs and HER-2 to the immunohistochemical panel.

Keywords

brain metastasis; breast cancer; diagnosis; comedonecrosis; solid growth pattern

Subject

Medicine and Pharmacology, Pathology and Pathobiology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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