Glycogen-rich carcinomas of the breast display unique characteristics with respect to proliferation and the frequency of oligonucleosomal fragments.

We determined the proliferation rate and apoptotic activity of glycogen-rich carcinomas of the breast as opposed to non-clear cell tumors by means of MIB-1 immunohistochemistry and in situ detection of oligonucleosomal fragments (TUNEL reaction). The retrospective biopsy series included six invasive clear cell carcinomas of the glycogen-rich type as well as 15 randomly selected cases of invasive ductal carcinoma without evidence of glycogen storage. Three patients in the clear cell group and seven patients in the control cohort developed lymph-node metastasis. The MIB-1 labeling index of glycogen-rich carcinomas averaged 9.05%, while that of the controls was 30.03%. Apoptotic nuclei were present in a mean of 1.26% of glycogen-rich carcinoma cells. The control tumors exhibited an average apoptotic frequency of 5.85%. Tumor size, hormone receptor status, and presence or absence of lymph node involvement were found not to correlate with either proliferation or apoptosis. We conclude that glycogen-rich breast carcinomas are characterized by a peculiar 'low proliferation-low apoptosis' cell kinetic profile. The aggressive clinical behavior of these neoplasms may possibly be accounted for by an ineffective apoptotic elimination of otherwise slowly proliferating tumor cells.