Tumor invasion and metastatic status still lead the poor prognostic in breast cancer. β-Catenin and e-cadherin are components of cadherin-based cell-to-cell adhesion and also an important intermediate in several signal transduction pathways, including the
Expression of β-catenin and e-cadherin in breast ductal carcinoma in situ and their association with survival: follow
up of 9.0 years
Authors : Giuliano M. Duarte1, Helena Slongo1, Marcelo L. Montenegro 1, Fernando Tocchet1, Juliana Espinola1, Fernando
Augusto Soares2, Priscila Marshall 1, Geisilene R. P. Silva1
Institutions: 1 Woman‘ Hospital Prof. Dr. José Aristodemo Pinotti (CAISM), State University of Campinas (UNICAMP),
Campinas, Brazil; 2 AC Camargo Cancer Center, São Paulo, Brazil
Introduction: Tumor invasion and metastatic status still lead the poor prognostic in breast cancer. β-Catenin and e-cadherin
are components of cadherin-based cell-to-cell adhesion and also an important intermediate in several signal transduction
pathways, including the Wnt pathway. Both are related to invasion, progression, and recurrence of cancer, but there are only
few studies regarding in ductal carcinoma in situ (DCIS). The aim of study is to evaluate β-catenin and e-cadherin expression
in pure DCIS and correlate these expressions with immunohistochemistry pattern, disease free survival and local recurrence.
Methods: A retrospective cohort study was performed using the records from 1999 to 2009 in our Institution. The medical
files of all patients with pure DCIS were reviewed and clinical, treatment and local of recurrence data were obtained. A tissue
microarray paraffin block (TMA) was constructed from all biopsies. The TMA was submitted to immunohistochemical
staining for β-catenin, e-cadherin, claudin-4, estrogen receptor, progesterone receptor, HER-2 and Ki-67. β-Catenin and ecadherin
were categorized on low or high expression depending on score intensity and quantity.
Results: It was included 137 patients with pure DCIS and 68 could have TMA analyzed for β-catenin and e-cadherin. The
mean diagnostic age was 52.31±11.12 years. Total local recurrence rate was 11.76% (50.0% were invasive carcinoma) after
median follow up of 9.06 years. High expression of β-catenin and e-cadherin were 71.93%, and 87.5%, respectively. High
expression of β-catenin was related to high expression of claudin-4 (P=0.017), e-cadherin (P=0.041), positive estrogen
receptor (P= 000.8), and positive progesterone receptor (P=0.048), but not to HER-2 and Ki-67. High expression of e-cadherin
was associated with high expression of claudin-4 (P= 0.005) and β-catenin (P=0.017), but not others variables. There was no
difference in local disease free survival between high and low expression of β-catenin (P=0.955) and e-cadherin (P=0.890).
Conclusion: High expression of β-catenin and e-cadherin was more frequent than low expression in DCIS. Although, β-
catenin was related to others adhesion components (as claudin and E-cadherin), and hormonal receptors (that are known
prognostic factors), there was no association of local recurrence or disease free survival. E-cadherin expression was also not
correlated with disease free survival.
Keywords: ductal carcinoma in situ; β-catenin; e-cadherin; survival