Breast Pathology
Amirhossein Jafarian; Mohaddeseh Shahraki; Samaneh Sajjadi; Behrooz Daneshmand
Abstract
Background: Breast sarcoma is a rare, but aggressive tumor. There are few case reports in the literature and several aspects of this disease are still not completely comprehended. Therefore, reporting new cases can help to enrich the literature.Case Presentation: We report a case with a breast mass and ...
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Background: Breast sarcoma is a rare, but aggressive tumor. There are few case reports in the literature and several aspects of this disease are still not completely comprehended. Therefore, reporting new cases can help to enrich the literature.Case Presentation: We report a case with a breast mass and pus secretion from her right breast, misdiagnosed as having an abscess and mistreated by antibiotics. The patient was referred for an ultrasound examination and mammography, and a needle biopsy was performed that suggested an aggressive tumor. By the pathologist’s suggestion, a total mastectomy of the right breast was performed with the excision of sentinel nodes. A pathological examination revealed high-grade undifferentiated pleomorphic sarcoma (UPS) without vascular or lymph node invasion as the final diagnosis. The patient underwent postoperative chemotherapy and is currently in good condition.Conclusion: This case emphasizes considering this rare tumor when approaching a breast mass. Performing surgery with adequate resection margin can improve the patient’s prognosis. Some cases reporting lung and brain metastasis suggest breast UPS is a more aggressive tumor than other breast sarcomas. Total mastectomy with negative margins and free-of-tumor lymph nodes may be the key to improved prognosis in such patients.
Breast Pathology
Zeinab Vosough; Shima Golbini; Majid Sharbatdaran; Akramossadat Hosseini
Abstract
Background & Objective: Breast cancer is the most common malignancy in Iranian women and worldwide. Lymphatic vessel invasion (LVI) was found to be an independent prognostic factor in many carcinomas, including invasive carcinoma of the breast. The aim of this study was to compare the hematoxylin ...
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Background & Objective: Breast cancer is the most common malignancy in Iranian women and worldwide. Lymphatic vessel invasion (LVI) was found to be an independent prognostic factor in many carcinomas, including invasive carcinoma of the breast. The aim of this study was to compare the hematoxylin and eosin (H&E) staining method and the use of the immunohistochemistry (IHC) marker, D2-40, for evaluating LVI in breast carcinoma specimens. Materials & Methods: The study was conducted on 50 patients undergone surgery between the years 2010 and 2015 in Rohani Hospital, Babol, Iran with invasive carcinoma of the breast with Census sampling method. LVI was assessed using H&E staining and two IHC markers, i.e., D2-40 and CD31, by two surgical pathologists. Results: LVI was detected in 25 (50%) patients by H&E and in 14 (28%) patients by D2-40. Twelve out of 25 patients with positive LVI in H&E were confirmed by D2-40 and 2 out of 25 patients with negative lymphatic vessel in H&E. Only one case showed weak staining of CD31 proving LVI. These results showed a significant difference between the H&E staining and D2-40 IHC study for LVI detection (p =0.004). Conclusion: The D2-40 IHC marker is helpful in the diagnosis and confirmation of LVI in invasive carcinoma of the breast. CD31 is not suitable for the evaluation of lymphatic vessels.
Breast Pathology
Maryam Kadivar; Fatemeh Aram
Abstract
Background & Objective:Ki-67 evaluation is an essential tool to define luminal A and B breast cancers, which is not yet systematized. The International Ki67 in Breast Cancer Working Group suggests the counting of 500 or 1000 cancer cells, which is a time-consuming process. Therefore, novel methods, ...
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Background & Objective:Ki-67 evaluation is an essential tool to define luminal A and B breast cancers, which is not yet systematized. The International Ki67 in Breast Cancer Working Group suggests the counting of 500 or 1000 cancer cells, which is a time-consuming process. Therefore, novel methods, such as the Eye-10 method and stepwise counting strategy, are proposed to facilitate measurement. Methods:Immunohistochemical staining of Ki67 was performed on 100 hormone-receptor-positive invasive ductal carcinoma specimens. Ki67LI was evaluated for each case, and then results were dichotomized by a cut-off point of 20%. Next, for each sample, an expert pathologist visually assessed percentages of Ki67-positive cells in 10% intervals at a glance (Eye-10 method). Finally, by using a dynamic process with rejection regions, Ki67 was defined so if the estimate belonged to the upper or lower rejection region, the Ki67 status had been determined and if the rejection region could not be reached after counting the maximum number of 400 tumor cells, the specimen was regarded as equivocal (stepwise counting strategy).Results:The comparison between Eye-10 and Ki67LI revealed almost perfect agreement (kappa coefficient =0.889), and the concordance between the stepwise counting strategy and Ki67LI was substantial (kappa coefficient =0.639).Conclusion:Both two methods left some results in the gray/intermediate zone, which is unavoidable. Both methods are much faster and simpler than evaluation of Ki67LI and are also reliable. Regarding the gray zone in both methods, further improvements in the methodology, as well as more analytical studies, are needed.
Gynecologic Pathology
Maryam Kazemi Aghdam; Seyed Alireza Nadji; Azadeh Alvandimanesh; Maliheh Khoddami; Yassaman Khademi
Abstract
Background & Objective: Malignant breast tumors, which are one of the most important deadly cancers in women, like many other cancers, are proposed to be related to viruses etiologically. Proper management of breast carcinoma necessitates an identification of the etiological factors. Human Papilomavirus is ...
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Background & Objective: Malignant breast tumors, which are one of the most important deadly cancers in women, like many other cancers, are proposed to be related to viruses etiologically. Proper management of breast carcinoma necessitates an identification of the etiological factors. Human Papilomavirus is considered to have an etiological role in breast carcinoma. We carried out this study to find out if Human Papilomavirus-DNA is present in the malignant and benign breast tissue in our patients. Methods: Seventy five paraffin-embedded breast cancer tissues and 75 normal breast tissues and benign breast lesions were examined in this study (case-control) to look for Human Papilomavirus-DNA employing Nested Polymerase Chain reaction. The tissues were examined over a period of ten years in the pathology department of the Pathobiology Laboratory Center of Tehran. Result: No Human Papilomavirus-DNA was found in any of the malignant or control group specimens. Conclusion: Our results showed no evidence of Human Papilomavirus in cancerous and benign tissues, which is consistent with some other studies in English medical literature. More investigations using more specimens from different parts of the country are required to confirm the presence or absence of any connection between Human Papilomavirus and development of breast carcinoma in Iran.
Breast Pathology
Akbar Safaei; Ahmad Monabati; Maral Mokhtari; Mehdi Montazer
Abstract
The most widely used guideline for the breast cancer biomarker assessment and reporting (the 2013 ASCO/CAP guideline) does not state the unusual occurrence of cytoplasmic Her2/neu staining (1, 2).
We recently encountered a T2N1Mx ductal adeno-carcinoma which consisted of two dissimilar tumor cell populations. ...
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The most widely used guideline for the breast cancer biomarker assessment and reporting (the 2013 ASCO/CAP guideline) does not state the unusual occurrence of cytoplasmic Her2/neu staining (1, 2).
We recently encountered a T2N1Mx ductal adeno-carcinoma which consisted of two dissimilar tumor cell populations. The more prominent population (75% of tumor cells) was made up of sheets of neuroendocrine-like cells (NEL) and the other tumor cell population had a usual adenocarcinomatous histomorphology (UAC) (Fig. 1A). The NEL was ER+ (clone 073), PgR-(clone 636), 40% ki67 with distinct dot-like cytoplasmic Her2 staining (clone CB11) which is considered as negative regarding the current guidelines. The UAC was ER+, PgR+, 20% ki67, and Her2 negative (Fig. 1A-C). Moreover, NEL did not react with either chromogranin or synaptophysin, but it expressed neuron-specific enolase (NSE). Dual color Her2/neu chromogenic in situ hybridization probes (chromogenic ISH) established that both components were not amplified for this oncoprotein gene (Fig. 1D).
Sanjay Kumar; Jyoti Sharma; Megha Ralli; Gurpreet Singh; Sonu Kalyan; Rajeev Sen
Volume 11, Issue 5 , October 2016, , Pages 469-473
Abstract
Primary soft tissue sarcomas of the breast constitute less than 5% of all soft tissue sarcomas and less than 1% of malignant breast cancers. The rarity of this tumor limits most studies to small retrospective case reviews and case reports. Primary breast sarcomas are locally aggressive tumors as evidenced ...
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Primary soft tissue sarcomas of the breast constitute less than 5% of all soft tissue sarcomas and less than 1% of malignant breast cancers. The rarity of this tumor limits most studies to small retrospective case reviews and case reports. Primary breast sarcomas are locally aggressive tumors as evidenced by the high rate of local recurrence when excisional surgery is performed. A contemporary multidisciplinary approach to therapy including surgery, radiation, and chemotherapy is advocated. Herein, we report a case of 45-yr-old female, who presented with a large ulcerated breast mass and was diagnosed as carcinoma breast on fine needle aspiration. Modified radical masectomy was performed and was diagonsed with primary breast stromal sarcoma on histopathology, which is a rare entity.
Sepideh Siadati; Majid Sharbatdaran; Novin Nikbakhsh; Naser Ghaemian
Abstract
Background and Objectives: Breast cancer is the most common malignancy among women in the world. The aim of this study was to assess estrogen receptor (ER), progesterone receptor (PR) and HER-2/neu of infiltrating ductal carcinoma (IDC) with tumor size, histologic grade, lymph node metastasis and age. ...
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Background and Objectives: Breast cancer is the most common malignancy among women in the world. The aim of this study was to assess estrogen receptor (ER), progesterone receptor (PR) and HER-2/neu of infiltrating ductal carcinoma (IDC) with tumor size, histologic grade, lymph node metastasis and age. Methods: This study was carried out on 300 tissue blocks ofpatients with IDC who underwent mastectomy from 2007 to 2011 in Shahid Beheshti Hospital, affiliated to Babol University of Medical Sciences, Babol, Iran. Data including age, tumor size, and histologic grade and lymph node status retrieved from pathology department. Result: Themean age of the patients was 40.2±2.3 (ranged 19-82 years). ER and PR were positively correlated with each other (P= 0.001) and they inversely correlated with HER-2/neu (P=0.001). We observed correlation between ER and PR expression and low histologic grade (P= 0.001) and HER-2/neu expression and high histologic grade (P= 0.003). There was correlation between HER-2/neu expression and lymph node involvement (P=0.03). None of these makers showed correlation with age and tumor size (P> 0.05). Conclusion: Our findings indicate the importance of ER, PR and HER-2/neu expression as prognostic factors for therapeutic decision. How to cite this article: Siadati S, Sharbatdaran M, Nikbakhsh N, Ghaemian N. Correlation of ER, PR and HER-2/Neu with other Prognostic Factors in Infiltrating Ductal Carcinoma of Breast. Iran J Pathol. 2015;10(3):221-6.
Eswari Varadharajan; Shanmuga Priya; Geetha Prakash; Archana Mugundan; Praveen Easwaramurthi
Abstract
Mucinous carcinoma of the breast is a well-differentiated type of adenocarcinoma accounting for 2-5% of all breast cancers. Pure mucinous carcinoma of the breast has a favorable prognosis, usually seen in post-menopausal women. Neuroendocrine differentiation has been described in both in-situ and infiltrating ...
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Mucinous carcinoma of the breast is a well-differentiated type of adenocarcinoma accounting for 2-5% of all breast cancers. Pure mucinous carcinoma of the breast has a favorable prognosis, usually seen in post-menopausal women. Neuroendocrine differentiation has been described in both in-situ and infiltrating breast cancers .Mucinous carcinomas of the breast appear to have the greatest association with neuroendocrine differentiation. Chromogranin A and synaptophysin are specific immunohistochemical markers of neuroendocrine differentiation. We report a case of mucinous carcinoma of the breast with neuroendocrine differentiation in a 67-year-old female who was treated surgically in a classical manner. How to cite this article: Varadharajan E, Priya S, Prakash G, Mugundan A, Easwaramurthi P. Mucinous Carcinoma of the Breast with Neuroendocrine Differentiation. Iran J Pathol. 2015;10(3):231-6.
Deepti Gupta; Veena Gupta; Nisha Marwah; Meenu Gill; Sumiti Gupta; Gopal Gupta; Promil Jain; Rajeev Sen
Abstract
Background and Objective: Breast cancer is the commonest cancer of Indian women. Estrogen and Progesterone expression is seen in benign breast lesions and in breast carcinoma associated with good prognostic parameters and it correlates well with response to hormone therapy. Although a lot of studies ...
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Background and Objective: Breast cancer is the commonest cancer of Indian women. Estrogen and Progesterone expression is seen in benign breast lesions and in breast carcinoma associated with good prognostic parameters and it correlates well with response to hormone therapy. Although a lot of studies have been conducted in the past on hormone receptor expression in breast cancer and few have correlated them with other prognostic parameters of breast cancer, the present study was intended to document the prevalence of hormone receptor positive breast carcinomas in our population; their importance in benign breast diseases; to document a reliable scoring system of hormone receptors expression by Quick scoring; to correlate them with most of the proven prognostic parameters of breast carcinoma. Methods: Tissue specimens from 25 patients with benign breast disease and 50 patients with breast carcinoma were assayed for estrogen (ER) and progesterone (PR) receptors using Quick scoring. ER/PR expression in breast carcinomas was correlated with various prognostic parameters including patients’ age, menopausal status, tumor size, type, MBR grade, NPI, lymphatic vessel invasion, lymph node stage, lymphomononuclear invasion, elastosis and HER2/neu status. Result: Scoring of steroid receptors paralleled intensity of hyperplasia in benign breast diseases but in breast carcinoma, it was inversely correlated with grade of tumor, NPI, HER2/neu status, tumor necrosis, lymphomononuclear infiltrate and elastosis. We found no relationship with tumor size, lymph node status or age. Conclusion: Assessment of hormone receptors for clinical management of breast cancer patients is strongly advocated to provide prognostic information and best therapeutic options
Ali Eslamifar; Amitis Ramezani; Kayhan Azadmanesh; Farahnaz Bidari-Zerehpoosh; Mohammad Banifazl; Arezoo Aghakhani
Abstract
Background and Objectives: Breast cancer is the most common malignancy in women throughout the world. There are controversial reports on the role of human papillomavirus (HPV) infection in breast carcinogenesis. The aim of this study was to assess the presence of HPV-DNA in invasive breast carcinoma ...
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Background and Objectives: Breast cancer is the most common malignancy in women throughout the world. There are controversial reports on the role of human papillomavirus (HPV) infection in breast carcinogenesis. The aim of this study was to assess the presence of HPV-DNA in invasive breast carcinoma to determine the association between HPV infection and breast carcinoma. Methods: The study included formalin-fixed paraffin-embedded tissue samples of 100 cases with invasive ductal carcinoma of breast and 50 control tissues of mammoplasty specimens. HPV-DNA was purified and amplified through GP5+/GP6+ and MY09/MY11 primers. Results: All tested carcinomas as well as normal tissues were negative for all types of HPV in PCR assay. Conclusion: Our results do not support the association between HPV infection and breast carcinoma. Further studies involving larger number of cases are required to elucidate the role of HPV infection in breast carcinogenesis.
Ehsan Malekianzadeh; Sedigheh Khazaei; Babak Izadi; Mahtab Rahbar
Volume 9, Issue 4 , October 2014, , Pages 268-272
Abstract
Although breast tuberculosis still remains rare, but in endemic countries should be in differential diagnosis of breast cancer and abscess. Imaging modalities cannot distinguish between cancer and tuberculosis. Acid fast bacilli stain; culture and PCR are helpful diagnostic methods but unfortunately ...
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Although breast tuberculosis still remains rare, but in endemic countries should be in differential diagnosis of breast cancer and abscess. Imaging modalities cannot distinguish between cancer and tuberculosis. Acid fast bacilli stain; culture and PCR are helpful diagnostic methods but unfortunately are not very sensitive. Negative results do not rule out this diagnosis, so it seems definite diagnosis can be made by open biopsy and histologic evidence (granuloma tissues). In this case, a 33 years old woman was referred to the Infectious Ward in Imam Reza Hospital, Medical University of Kermanshah, western Iran in 2011; complaining of one lump in her left breast which did not response to usual therapy (painkillers and antibiotics). Fine needle aspiration for histologic and cytologic evaluations were negative but open biopsy showed granulomatous tissues, anti-tuberculosis chemotherapy was begun and response was significant then PCR was reported positive. We think in endemic area, empirical treatment can be started based on histological evidence and proper clinical manifestation.
Nasser Ghaemian; Sepideh Siadati; Novin Nikbakhsh; Mohaddeseh Mirzapour; Hanieh Askari; Samaneh Asgari
Volume 8, Issue 4 , October 2013, , Pages 241-246
Abstract
Background and Objectives:Breast cancer is the most common cancer among women worldwide. Fine needle aspiration biopsy (FNAB) is one of the methods of breast biopsy which is fast, easy and cost effective. The aim of this study was to evaluate the concordance rate between pathologic results of sonography ...
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Background and Objectives:Breast cancer is the most common cancer among women worldwide. Fine needle aspiration biopsy (FNAB) is one of the methods of breast biopsy which is fast, easy and cost effective. The aim of this study was to evaluate the concordance rate between pathologic results of sonography or stereotaxy guided FNAB and guided core needle biopsy (CNB) in the evaluation of breast lesions.
Materials & Methods: During December 2010 until March 2011, 36 female patients with 37 breast lesions referred to FNAB and CNB with the guide of sonography in 35 lesions and with the guide of stereotaxy in 2 lesions. The kappa statistic used to calculate the concordance coefficient.
Results: The concordance rate between guided – FNAB and guided – CNB was 93% with using kappa coefficient. In 5 patients, subjected to breast surgery, malignancy was reported as well as in guided-FNAB or guided-CNB.
Conclusion: Because of high concordance between these two techniques in the assessment of breast lesions, guided FNAB is recommended in the first step. Guided-CNB can be reserved for lesions with insufficient pathology results by guided-FNAB.
Sushma Ramraje; Sameer Ansari; Shantilal Sisodia; Niddhi Chaturvedi; Varsha Bhatia; Aparagita Goel
Volume 8, Issue 3 , July 2013, , Pages 199-203
Abstract
Mucinous carcinoma of the breast is a well differentiated, rare histological type of invasive ductal carcinoma, seen in oldest median age (69 years). We describe a case of a 60 yr old female with large right breast mass of 10 years duration with no nodal involvement. The reasons to present this case ...
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Mucinous carcinoma of the breast is a well differentiated, rare histological type of invasive ductal carcinoma, seen in oldest median age (69 years). We describe a case of a 60 yr old female with large right breast mass of 10 years duration with no nodal involvement. The reasons to present this case are 1) Because of its rarity. 2) Despite having a large tumour size, the axillary lymph node is not involved, hence rendering favourable prognosis. 3) Fine needle aspiration cytology can be used as an important tool in early detection of pure mucinous carcinoma of breast. 4) Careful clinical examination should be performed when suspicious for mucinous carcinoma because lymph node metastasis changes prognosis and treatment modalities .5) Pure mucinous carcinomas should be distinguished from mixed neoplasm, because the latter have a poorer prognosis that is most likely related to the extent of invasive carcinoma lacking extracellular mucin.
Dhaneshor Sharma; Tomcha Singh; Rajesh Singh Laishram; Ranjit Singh
Volume 6, Issue 3 , June 2011, , Pages 143-146
Abstract
Breast metastasis of ovarian carcinoma is rare. To date, only 39 cases have been reported in the English-language literature so far. We are herewith reporting a primary ovarian papillary serous cyst adenocarcinoma metastasing ...
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Breast metastasis of ovarian carcinoma is rare. To date, only 39 cases have been reported in the English-language literature so far. We are herewith reporting a primary ovarian papillary serous cyst adenocarcinoma metastasing to breast and epsilateral supraclavicular node in a 58 year old female as the first case in our centre, located at North-East India. The purpose of reporting this case is to emphasize the need of examining breasts in patients of ovarian cancer and the need to exercise meticulous care to exclude second primary at breast from possible secondaries at breast from ovarian can cer.
Ali Yaghobi; Payam Azadeh; Sh . Moghadam; Behrouz Shafaghi
Volume 5, Issue 1 , January 2010, , Pages 43-46
Abstract
Although most breast cancers are adenocarcinomas of the mammary gland, primary breast sarcomas may also arise from mammary gland mesenchymal tissue. Sarcomas represent less than 1% of primary breast neoplasms. These tumors are at high risk of recurrence and are known to have poor prognosis. Surgical ...
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Although most breast cancers are adenocarcinomas of the mammary gland, primary breast sarcomas may also arise from mammary gland mesenchymal tissue. Sarcomas represent less than 1% of primary breast neoplasms. These tumors are at high risk of recurrence and are known to have poor prognosis. Surgical resection is the primary treatment for these lesions and axillary lymph node dissection is not routinely indicated in the setting of a clinically negative axilla. In this report, we introduce a patient with breast stromal sarcoma based on surgical pathology that has experienced axillary lymph node recurrence later during follow up period.
Alireza Abdollahi; Issa Jahanzad; Peyman Mansuri Mehrabani
Volume 3, Issue 2 , March 2008, , Pages 88-94
Abstract
Background and Objective: In this study, we explored expression rate, some biomarkers affecting the prognosis of the breast carcinoma, and the relationship between these markers and clinicopathologic features of the disease as well as the relationship between each of these markers through a tissue ...
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Background and Objective: In this study, we explored expression rate, some biomarkers affecting the prognosis of the breast carcinoma, and the relationship between these markers and clinicopathologic features of the disease as well as the relationship between each of these markers through a tissue array technique. Materials and Methods: This study was an observational and cross-sectional study. From 100 breast samples which had been diagnosed as invasive ductal carcinoma, blocks were prepared through a tissue array method and were stained by monoclonal antibodies of the markers. All data were analyzed using SPSS program. Results: The appearance rate of EGF-R marker had a direct relationship with the degree of malignancy (p=0.026), metallothionein marker with the mean number of mitosis (p=0.044), sialyl-Tn marker with the macroscopic size of tumor (p=0.036), the appearance of cyclin B1 marker with the appearance of metallothionein marker (p=0.012), and the appearance rate of EGF-R marker had a reverse relationship with Nm23 (p=0.020). Conclusion: Through investigating the relationship between some biomarkers such as EGF-R and metallothionein and the clinicopathogenic features of tumor or the relationship between each marker and the other parameters, we can assess the state of invasion and metastasis process or the degree of its malignancy or determine its prognosis.
Peyman Mohammadi Torbati; Pejman Fard Esfehani
Volume 1, Issue 4 , September 2006, , Pages 149-154
Abstract
Background and Objective: Since the advent of mammography screening, ductal carcinoma in situ (DCIS) of the breast has been diagnosed increasingly. In contrast to the situation in invasive breast carcinoma, there are only a few reports on androgen receptor (AR) status in DCIS and few reports on estrogen ...
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Background and Objective: Since the advent of mammography screening, ductal carcinoma in situ (DCIS) of the breast has been diagnosed increasingly. In contrast to the situation in invasive breast carcinoma, there are only a few reports on androgen receptor (AR) status in DCIS and few reports on estrogen (ER) and progesterone (PR) receptors. Materials and Methods: AR expression was examined in 51 cases of DCIS of the breast and correlated to the degree of differentiation and ER/PR expression status in accordance to immunohistochemical results. Results: AR immunoreactivity was noted in 17 of the cases, whereas the other 34 cases were negative. There was also no significant association between AR expression and the degree of differentiation of DCIS; two of the 11 well-differentiated DCIS cases, nine of the 17 intermediately differentiated cases, and six of the 23 poorly differentiated cases were AR positive (p = 0.091). However, a strong association was shown between the expression of ER (p<0.001) and PR (p = 0.002) and the degree of differentiation of DCIS. In addition, no significant association was found between the expression of AR and the expression of ER (p = 0.37) or PR (p = 0.63) in DCIS of the breast. Conclusion: Clinically significant number of cases of DCIS of the breast expresses AR, which may affect accurate typing of DCIS. Moreover, the expression of AR (but not ER or PR) in DCIS does not appear to be associated with the degree of differentiation.
Alireza Monsef1; Fatemeh Eghbalian; S. Mahmoud Hessinipanah; Mohammad Abbasi4; Hossein Mahjoub
Volume 1, Issue 1 , January 2006, , Pages 7-12
Abstract
Objective: Breast cancer comprise approximately one third of malignant cases in women and is considered as the most common invasive condition in women at an age range of 15-54 years and as the second most prevalent cause of mortality at an age range of 55-74 years. Tumor inhibiting factor p53 is a vital ...
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Objective: Breast cancer comprise approximately one third of malignant cases in women and is considered as the most common invasive condition in women at an age range of 15-54 years and as the second most prevalent cause of mortality at an age range of 55-74 years. Tumor inhibiting factor p53 is a vital homeostatic regulator and its inactivation at the related gene or molecule could lead to tumor growth and development in various tissues. Therefore, in this research study it was tried to evaluate the diagnostic methods Ag-NOR and p53 immunohistochemistry in malignancy of mammary gland using cytochemical staining methods and its relationship with tumor grade. Materials and Methods: In this research study, 50 referred breast specimens to Deaprtment of Pathology (Sina Hospital, Hamedan) were studied. They were processed as usual and 3 micrometer sections were prepared from related blocks. Then, staining methods for nucleolus organizing regions (Ag-NOR) and p53 immunohistochemistry were applied. Out of these specimens, 41 had malignancy (40 cases of invasive ductal carcinoma and 1 case of invasive lobular carcinoma) and 9 cases were normal. The latter cases were compared with malignant ones. Tumor grade in studied individuals was I (3 cases; 7.3%), II (23 cases; 56.1%), and III (15 cases; 36.6%) respectively. Results: Statistical analysis of data showed that there is only a significant difference regarding frequency distribution of cluster shape and there is no such difference for satellite shape, satellite size, and cluster size. In addition, staining intensity for p53+, p53++, and p53+++did not show any significant difference in various grades of the disease. Using Spearman regression analysis, it was found out that there was a relationship between p53 negative and p53+ (r = 0.723) (p<0.01) and between p53+ and p53++ (r = 0.78). Furthermore, it was found out that a higher expression of p53 protein is negatively correlated with darklystained granules using silver nitrate method. Conclusion: These findings showed that higher expression of p53 protein is negatively correlated with darkly-stained granules using Ag-NOR method and this may indicate its antitumor activity. It appears that this method is an essential tool for evaluation of normal and malignant cases of breast tissue regarding its replication pattern and intensity and expression of those chromosomal segments which are involved in encoding of ribosomal RNA.
