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Open Access Research article

Versican but not decorin accumulation is related to malignancy in mammographically detected high density and malignant-appearing microcalcifications in non-palpable breast carcinomas

Spyros S Skandalis12, Vassiliki T Labropoulou3, Panagiota Ravazoula4, Eleni Likaki-Karatza5, Katalin Dobra6, Haralabos P Kalofonos3, Nikos K Karamanos1 and Achilleas D Theocharis1*

  • * Corresponding author: Achilleas D Theocharis atheoch@upatras.gr

  • † Equal contributors

Author Affiliations

1 Laboratory of Biochemistry, Department of Chemistry, University of Patras, Rio 26504, Greece

2 Ludwig Institute for Cancer Research, Uppsala Branch, Box 595, 75124 Uppsala, Sweden

3 Clinical Oncology Laboratory, Division of Oncology, Department of Medicine, University Hospital of Patras, Patras Medical School, Rio 26504, Greece

4 Department of Pathology, University Hospital of Patras, Rio 26504, Greece

5 Department of Radiology, University Hospital of Patras, Rio 26504, Greece

6 Department of Laboratory Medicine, Division of Pathology, Karolinska Institute, F-46 Huddinge University Hospital, SE-14186 Stockholm, Sweden

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BMC Cancer 2011, 11:314  doi:10.1186/1471-2407-11-314

Published: 26 July 2011

Abstract

Background

Mammographic density (MD) and malignant-appearing microcalcifications (MAMCs) represent the earliest mammographic findings of non-palpable breast carcinomas. Matrix proteoglycans versican and decorin are frequently over-expressed in various malignancies and are differently involved in the progression of cancer. In the present study, we have evaluated the expression of versican and decorin in non-palpable breast carcinomas and their association with high risk mammographic findings and tumor characteristics.

Methods

Three hundred and ten patients with non-palpable suspicious breast lesions, detected during screening mammography, were studied. Histological examination was carried out and the expression of decorin, versican, estrogen receptor α (ERα), progesterone receptor (PR) and c-erbB2 (HER-2/neu) was assessed by immunohistochemistry.

Results

Histological examination showed 83 out of 310 (26.8%) carcinomas of various subtypes. Immunohistochemistry was carried out in 62/83 carcinomas. Decorin was accumulated in breast tissues with MD and MAMCs independently of the presence of malignancy. In contrast, versican was significantly increased only in carcinomas with MAMCs (median ± SE: 42.0 ± 9.1) and MD (22.5 ± 10.1) as compared to normal breast tissue with MAMCs (14.0 ± 5.8), MD (11.0 ± 4.4) and normal breast tissue without mammographic findings (10.0 ± 2.0). Elevated levels of versican were correlated with higher tumor grade and invasiveness in carcinomas with MD and MAMCs, whereas increased amounts of decorin were associated with in situ carcinomas in MAMCs. Stromal deposition of both proteoglycans was related to higher expression of ERα and PR in tumor cells only in MAMCs.

Conclusions

The specific accumulation of versican in breast tissue with high MD and MAMCs only in the presence of malignant transformation and its association with the aggressiveness of the tumor suggests its possible use as molecular marker in non-palpable breast carcinomas.

Keywords:
proteoglycans; versican; decorin; mammographic density; malignant-appearing microcalcifications; non-palpable breast carcinomas