Invasive Ductal CA : Necrosis
Tumor necrosis is considered to be an independent prognostic factor in breast carcinoma. The significance of the amount of necrosis and its relative distribution within DCIS and invasive components as a prognostic indicator remains controversial. Some researchers have found that tumor necrosis as a predictor of recurrence was relevant only for the first 2 years after surgery. For those patients who remained recurrence-free for 10 years after surgical therapy, tumor necrosis was no longer a significant prognostic factor.
Extensively necrotic tumors are frequently ER-/PR- and are highly likely to progress (recurrence or death). Basal cell-like markers are expressed in a very high percentage of such cases. In summary, the presence of extensive necrosis is an adverse prognostic feature in invasive breast carcinomas. It indicates a rapidly dividing tumor that has outgrown its blood supply.