E-Cadherin Expression as a Cell Marker in Benign and Malignant Breast Lesions

Background: Breast cancer continues to be a major cause of morbidity and mortality throughout the world. The behaviour of breast cancer varies widely. Several parameters have been investigated to predict the prognosis in breast cancer. But still there is no single parameter that can predict prognosis in an individual patient. Among the novel prognostic markers is E-cadherin; a calcium-dependent epithelial cell adhesion molecule. Its loss has been associated with metastases, thereby providing evidence for its role as an invasion suppressor. This study was conducted to evaluate the expression of E-cadherin as epithelial cell marker in the differential diagnosis of benign and malignant breast lesions and to evaluate it’s role as a diagnostic bio marker in breast cancer.

Methods: This prospective study was carried out from November 2020 to November 2022 in the Department of Surgery, at Jawaharlal Nehru Medical College, Aligarh, India. The study was conducted on 117 patients presenting with breast lesions. A detailed history, complete physical examination and preliminary investigations were done. Histopathological examination one on formalin fixed and paraffin embedded tissue sections of breast lesion. Immunostatins for E-cadherin were employed on cases. The data was collected and analyzed using SPSS 2020.

Results: Most of the patients were below 30years of age (36.7%) and the mean age was 38.1±16.9 years. 54 patients (46.4%) were benign and 63 patients (53.6%) were malignant. Out of a total of 63 malignant breast lesions, Infiltrating ductal carcinoma Not otherwise specified (IDC NOS) was most frequent, comprising 34 cases (53.9%). We stained cases of carcinoma breast for E-cadherin. Out of 15 cases of Grade 1 IDC NOS, 11 (73.3%) showed 3+ proportion score, 3 (20.0%) cases showed 2+ score, whereas 1(6.6%) case showed 1+ score. Out of 12 cases of Grade 2 IDC NOS, 6 (50.0%) showed 3+ and 5 (41.6%) showed 2+ proportion score and 1 case (8.3%) showing 1+ score. Out of 7 cases of Grade 3 IDC NOS, 6 (85.7%) cases showed 2+ proportion score and 1 case (14.2%) showed 1+, none showed 3+ score. A statistically significant finding (p=0.0059) was seen between grade and E-cadherin score. A statistically significant (p=0.0169) between E-cadherin scoring on benign and malignant cases overall implying stronger expression of E-cadherin in benign lesions as compared to malignant ones.

Conclusion: It is concluded that expression of E-Cadherin is associated with benign or malignant nature of breast lesion, with expression stronger in benign. It has a prognostic value in IDC grading.