2012 Darbaker Prize: Morphometric Analysis of Nuclei, Lumens, and Shape of Lactiferous Ducts in Cancerous Breast Tissue

As the most common form of breast cancer in women, ductal carcinoma accounts for 70–80% of breast cancer cases. Pathologists often use the Nottingham grading system to assess the abnormality and aggressiveness of invading cancerous cells in ductal carcinoma. A grade of one to three is assigned using a point system based upon variation in nuclear appearance, tubule formation, and mitotic count, but these features are generally not quantified. We collected morphometric data on nuclei and ducts to attempt to quantify nuclear variation and tubule formation. Measurements of over 2000 nuclei and nearly 100 ducts were made using slides of normal breast tissue and the three grades of ductal carcinoma from anonymous patients at Pocono Medical Center. A ratio of luminal area to ductal area in cancerous tissue within each grade was also calculated, and shapes of duct outlines were examined. ANOVA revealed significant differences in nuclear diameter among grades: both diameter and variation in diameter increased with grade. Variability and irregularity of nuclear and duct shape also increased with grade. Lumen/duct area ratios decreased with severity of invasion and approached zero in grade three. Although preliminary, these morphometric data suggest that it may be possible to develop more objective and quantifiable criteria for grade designations.