[Expression of carbonic anhydrase IX in the breast carcinomas]. / Expresia karbonickej anhydrázy IX v karcinómoch prsníka.

OBJECTIVE: Carbonic anhydrase IX (CA IX) is one indicator of hypoxia in the tumor and its expression is associated with more aggressive forms of breast cancer. The aim of this study is to point out its own set of correlation between CA IX expression and selected morphological and biological indicators. TYPE OF STUDY: Cohort prospective study. SETTING: Department of Pathology of Slovak Medical University and St. Elisabeth Cancer Institute, Bratislava, Slovak Republic. METHODS: These were 145 cases of breast cancer aged 25 to 85 years (median 59 years) from the Register of the Institute of Pathology and Slovak Medical University and St. Elisabeth Cancer Institute in Bratislava for the period 1. 9. 2012 to 28. 2. 2013. In all cases were examined CA IX, estrogen receptor (ER), progesterone receptor (PR), HER2, p53 and Ki67 by immunohistochemistry. Typing, grading and staging of the disease were evaluated according to the classification systems currently in place. RESULTS: CA IX expression was demonstrated in 51 cases (35.2%). CA IX positivity correlated with the degree of differentiation (p = 0.0001), with ER status (p <0.0001) and PR (p <0.01) and HER2 (p <0.01) and proliferative activity as measured by Ki67 (p <0.001). HER2-positive cancers and triple-negative cancers were more frequently associated with the expression of CA IX compared with luminal subtypes (p <0.0001). The state of CA IX and age range of the tumor - pT and lymph node status - pN and p53 have not been shown statistically significant correlations. CONCLUSION: CA IX examination in breast cancer provides valuable information on the state of hypoxia in the tumor, thereby supplementing view of prognosis of the disease.

[Acatholytic variant of squamous carcinoma of the breast. A case report and review of literature]. / Akantolytický variant skvamózneho karcinómu prsnej zl'azy. Kazuistika a prehl'ad literatúry.

The acantholytic variant of squamous carcinoma (ASC) represents a rare type of metaplastic breast carcinoma with typical occurrence of pseudoglandular and pseudovascular structures, arising as a result of cohesion loss between the neoplastic cells. Up to the present, there have been only 10 cases of mammary ASC described in the English written literature. The authors present a case of a 57-year-old woman with a large (6 x 7 cm) suspicious lump on ultrasonography in her right breast treated by mastectomy with an ipsilateral axillary lymph node dissection due to histologically verified ASC. Additional postoperative staging computer tomography revealed metastatic foci in the left lungs, thus calling for adjuvant chemotherapy for the patient. Six months after setting the diagnosis, the patient is alive with a partial therapeutic response. In the differential diagnosis of ASC it is important to exclude angiosarcoma, phyllodes tumor and metastatic sarcomas to the breast. The useful tools for differentiation between the above-mentioned entities are extensive bioptic examination and detailed immunohistochemical staining, enabling the pathologist to exclude the endothelial lineage (using CD31 and CD34) and to verify the epithelial origin through the detection of cytokeratins (spectra of high-molecular weight cytokeratins). Furthermore, the ASC shows positive immunohistochemical staining for markers of the myoepithelial differentiation, e.g. cytokeratin 14, CD10 and p63, suggesting an immature cell population with basaloid features. In conclusion, as ASC is an aggressive subtype of the breast carcinoma with a poor prognosis, the correct diagnosis set by the pathologist is of great importance on the therapeutic management in affected patients.