INTRODUCTION: The bcl-2 gene encodes a protein that is involved in cell death regulation. Initially described in lymphomas, and later in epithelial tissues, its expression is often found in breast cancer, in association with favorable prognostic factors. Because fine-needle aspiration (FNA) biopsy has been established as a reliable method for the diagnosis and biologic characterization of breast cancer, we assessed bcl-2 expression on FNAs from primary breast cancer and evaluated its correlation with the corresponding histologic grade, scored on the subsequent surgical specimen, following the Scarff, Bloom and Richardson method (SBR). OBJECTIVES: To evaluate the bcl-2 protein expression on FNAs and correlate it with histologic grade on paraffin embedded material. METHODS: Bcl-2 expression was evaluated retrospectively by immunocytochemistry on 118 consecutive FNAs from patients with primary breast cancer. Histologic grade was assessed according to the SBR classification, on surgical specimen material from the same patients that underwent surgical resection of the lesion. A correlation was established. RESULTS: Bcl-2 was expressed in 77 of 118 FNAs (65.25%) and was correlated with histologic grade (p = 0,0022). CONCLUSIONS: Bcl-2 expression, evaluated by immunocytochemistry on FNAs from primary breast carcinoma, correlates with favorable prognostic factor. The positivity rate, as well as the inverse histologic grade correlation, is in agreement with previous published data. As FNA biopsy is used increasingly as a primary tool in the diagnosis of breast carcinoma, bcl-2 evaluation by immunocytochemistry on FNA may provide, in a near future, in addition to other biologic variables, useful information for prognostic and predictive purposes, particularly in patients considered as candidates for neo-adjuvant treatment.
Breast; Carcinoma; Fine needle aspiration; bcl-2; Immunocytochemistry; Prognosis
