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Journal of Mammary Gland Biology and... Jun 2015Tissue based research requires a background in human and veterinary pathology, developmental biology, anatomy, as well as molecular and cellular biology. This type of... (Review)
Review
Tissue based research requires a background in human and veterinary pathology, developmental biology, anatomy, as well as molecular and cellular biology. This type of comparative tissue biology (CTB) expertise is necessary to tackle some of the conceptual challenges in human breast stem cell research. It is our opinion that the scarcity of CTB expertise contributed to some erroneous interpretations in tissue based research, some of which are reviewed here in the context of breast stem cells. In this article we examine the dissimilarities between mouse and human mammary tissue and suggest how these may impact stem cell studies. In addition, we consider the differences between breast ducts vs. lobules and clarify how these affect the interpretation of results in stem cell research. Lastly, we introduce a new elaboration of normal epithelial cell types in human breast and discuss how this provides a clinically useful basis for breast cancer classification.
Topics: Animals; Carcinoma; Cell Differentiation; Cell Lineage; Female; Flow Cytometry; Histology, Comparative; Humans; Immunohistochemistry; Keratins; Mammary Glands, Animal; Mammary Glands, Human; Mice; Stem Cells
PubMed: 26286174
DOI: 10.1007/s10911-015-9341-4 -
Cureus Oct 2022Dermatofibrosarcoma protuberans (DFSP) is a rare, indolent, cutaneous sarcoma originating in the dermis, and although nearly half of cases occur on the trunk, DFSP of...
Dermatofibrosarcoma protuberans (DFSP) is a rare, indolent, cutaneous sarcoma originating in the dermis, and although nearly half of cases occur on the trunk, DFSP of the breast is exceedingly rare, and imaging findings may resemble primary breast neoplasms. In this case report, a previously healthy, middle-aged female patient presented to the clinic with the complaint of abnormal growth in her left breast, which had been gradually increasing in size over the course of four years. Imaging of the left breast demonstrated a large, exophytic, partially intradermal mass with internal vascularity, raising concern for a primary breast neoplasm. Ultrasound-guided core needle biopsy revealed a diagnosis of DFSP. She underwent successful left skin- and nipple-sparing mastectomy with complete resection of the mass with negative margins confirmed on surgical pathology. Recognizing key features of DFSP on conventional breast imaging modalities, such as mammography and ultrasound, can be helpful in differentiating DFSP from primary breast neoplasms, but imaging findings alone may be nonspecific and biopsy is necessary for a definitive diagnosis. On mammography, DFSP typically presents as an exophytic, gently lobulated, non-calcified, and circumscribed mass. On sonographic examination, DFSP appears as a circumscribed, parallel-oriented mass that is hypoechoic relative to the surrounding fat, with intervening echogenic bands, posterior acoustic enhancement, and intralesional hypervascularity visualized on color Doppler. Although DFSP is slow-growing with a low incidence of metastatic disease, it has a high local recurrence rate and aggressive local resection is necessary to minimize the chance of recurrence.
PubMed: 36397899
DOI: 10.7759/cureus.30175 -
Surgical Case Reports Nov 2023Primary angiosarcomas of the breast are rare and highly aggressive. We herein report a rare case of multiple angiosarcomas detected concurrently in both breasts.
BACKGROUND
Primary angiosarcomas of the breast are rare and highly aggressive. We herein report a rare case of multiple angiosarcomas detected concurrently in both breasts.
CASE PRESENTATION
A 49-year-old woman visited a doctor after noticing a lump in her right breast. At that time, mammography and ultrasonography revealed no abnormal findings in either breast. She was referred to our hospital 5 months later, because screening mammography had revealed a focal asymmetric density in her right breast. Ultrasonography showed ill-defined hyper- and hypo-echoic lesions in both breasts. Magnetic resonance imaging disclosed five heterogeneously enhanced masses (5.8 cm in maximum diameter) in the right breast and six enhanced masses (approximately 1-3 cm in diameter) in the left breast. Histological examination of core needle biopsies revealed proliferation of irregularly shaped vascular channels lined by atypical endothelial cells throughout the adipose tissue and lobules of the breasts, leading to a diagnosis of well-differentiated angiosarcoma. The lesions were assumed to be primary angiosarcomas, because she had neither a history of breast surgery nor of radiation therapy. She underwent bilateral mastectomies and postoperative chest wall irradiation. Computed tomography 11 weeks after the surgery revealed multiple, small, subcutaneous nodules in the chest wall that were suspected of being angiosarcoma metastases. We started chemotherapy (weekly paclitaxel 80 mg/m), which achieved shrinkage of these nodules within 2 months.
CONCLUSIONS
Early diagnosis, immediate initiation of local and systemic therapies, and intensive follow-up are important in improving the prognosis of angiosarcomas.
PubMed: 38015377
DOI: 10.1186/s40792-023-01782-w -
Surgical Case Reports Dec 2023Adenomyoepithelioma (AME) of the breast is an uncommon tumor characterized by the proliferation of ductal epithelial and myoepithelial cells with the heterogeneity....
BACKGROUND
Adenomyoepithelioma (AME) of the breast is an uncommon tumor characterized by the proliferation of ductal epithelial and myoepithelial cells with the heterogeneity. Although benign AME is relatively easy to differentiate from breast cancer by core needle biopsy (CNB) alone, a definitive diagnosis is often difficult. The imaging findings of AME are also variable, and there are particularly few reports about radiological features, including contrast-enhanced magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) values in AME.
CASE PRESENTATION
We present two cases of benign AME. Case 1 is a 30-year-old woman with a history of asthma. The cystic tumor shows smooth borders, and the intracystic solid component is irregular in shape and high vascularity. The pathological findings of the tumor were benign on CNB. The MRI scan showed a decreased ADC value. Case 2 is a 60-year-old woman with only a history of arrhythmia. The tumor shows a lobulated mass with cystic space and coarse calcifications. The pathological findings of the tumor were found to be benign by CNB. Dynamic MRI scan showed a fast washout pattern with a decreased ADC value. Both patients underwent excisional biopsy to confirm the diagnosis, and the pathological diagnosis was benign AME in both cases.
CONCLUSIONS
The AME of the breast has little specific imaging information, so it can be difficult to diagnose based on pathological findings of biopsy specimen. In our case, the ADC values were exceptionally low, contrary to previous reports. It is essential to carefully diagnose AME, considering the discrepancies in imaging findings observed in this case.
PubMed: 38123876
DOI: 10.1186/s40792-023-01793-7 -
Cancer Prevention Research... Nov 2015Estrogen receptor (ER) β is highly expressed in normal breast epithelium and a putative tumor suppressor. Atypical hyperplasia substantially increases breast cancer...
Estrogen receptor (ER) β is highly expressed in normal breast epithelium and a putative tumor suppressor. Atypical hyperplasia substantially increases breast cancer risk, but identification of biomarkers to further improve risk stratification is needed. We evaluated ERβ expression in breast tissues from women with atypical hyperplasia and association with subsequent breast cancer risk. ERβ expression was examined by immunohistochemistry in a well-characterized 171-women cohort with atypical hyperplasia diagnosed 1967-1991. Nuclear ERβ percent and intensity was scored in the atypia and adjacent normal lobules. An ERβ sum score (percent + intensity) was calculated and grouped as low, moderate, or high. Competing risks regression was used to assess associations of ERβ expression with breast cancer risk. After 15-year median follow-up, 36 women developed breast cancer. ERβ expression was lower in atypia lobules in than normal lobules, by percent staining and intensity (both P < 0.001). Higher ERβ expression in the atypia or normal lobules, evaluated by percent staining, intensity or sum score, decreased the risk of subsequent breast cancer by 2-fold (P = 0.04) and 2.5-fold (P = 0.006). High normal lobule ERβ expression conferred the strongest protective effect in premenopausal women: the 20-year cumulative incidence of breast cancer was 0% for women younger than 45 years with high versus 31% for low-moderate ERβ expression (P = 0.0008). High ERβ expression was associated with a significantly decreased risk of breast cancer in women with atypical hyperplasia. These data suggest that ERβ may be a useful biomarker for risk stratification and a novel therapeutic target for breast cancer risk reduction.
Topics: Adult; Aged; Aged, 80 and over; Algorithms; Biomarkers, Tumor; Breast Neoplasms; Cohort Studies; Estrogen Receptor beta; Female; Follow-Up Studies; Gene Expression Regulation, Neoplastic; Humans; Hyperplasia; Immunohistochemistry; Middle Aged; Multivariate Analysis; Risk Factors
PubMed: 26276747
DOI: 10.1158/1940-6207.CAPR-15-0198 -
Medicine Nov 2022Alveolar soft part sarcoma (ASPS) is a rare tumor but potentially fatal condition. Understanding the imaging and clinical features of ASPS is of certain value for... (Review)
Review
BACKGROUND
Alveolar soft part sarcoma (ASPS) is a rare tumor but potentially fatal condition. Understanding the imaging and clinical features of ASPS is of certain value for preoperative qualitative diagnosis and clinical treatment of tumors. Nevertheless, there have been only 11 documented case reports describing the sonographic features in the English literature.
METHODS
Three patients with confirmed ASPS occurring primarily in the limbs were enrolled in this study. Complete surgical excision was performed with conservative limb function. We pay particular attention to the ultrasonographic features and performed a literature review of ASPS cases.
RESULTS
With regular surveillance, one patient had no symptom recurrence and two developed lung and/or breast metastasis later. The specific sonographic findings were heterogeneous hypoechoic, well-circumscribed, and lobulated or round contours on grayscale images, abundant flow signals of intratumoral and extratumoral tubular structures on color Doppler images.
CONCLUSION SUBSECTIONS
Its low incidence rate and lack of characteristic clinical manifestations often result in misdiagnosis of ASPS. The specific sonographic findings may add useful diagnostic information.
Topics: Humans; Female; Sarcoma, Alveolar Soft Part; Ultrasonography; Diagnostic Imaging; Breast Neoplasms; Diagnostic Errors
PubMed: 36401473
DOI: 10.1097/MD.0000000000031905 -
Thoracic Cancer Apr 2024The aim of this study was to compare breast cancer patients with pulmonary oligometastases (POM) and primary lung cancer (PLC) and to assess whether there were...
BACKGROUND
The aim of this study was to compare breast cancer patients with pulmonary oligometastases (POM) and primary lung cancer (PLC) and to assess whether there were differences in clinical features, CT features, and survival outcomes between the two groups.
METHODS
From January 2010 to December 2021, the clinical records of 437 with malignant pulmonary nodules who had breast cancer patients were reviewed. POM was identified in 45 patients and PLC in 43 patients after the initial detection of pulmonary nodules. The clinicopathological characteristics, CT appearance of pulmonary nodules, and survival of the two groups were compared.
RESULTS
Stage II to IV breast tumors (p < 0.001), high pathological grade of breast cancer (p = 0.001), low proportion of luminal-type breast cancer (p = 0.003), and the higher serum CYFRA 21-1 level (p = 0.046) were the clinical characteristics of pulmonary nodules suggestive of POM rather than PLC. The CT features of lung nodules indicative of PLC rather than POM were the subsolid component (p < 0.001), lobulation (p = 0.010), air bronchogram (p < 0.001) and pleural indentation (p = 0.004). Ten-year survival rate for PLC was 93.2%, which was higher compared with 57.8% in those with POM (p = 0.001).
CONCLUSIONS
Elevated serum CYFRA 21-1 levels and late-stage breast cancer may be beneficial for the diagnosis of POM. CT imaging appearances of the subsolid component, lobulation, air bronchogram, and pleural indentation increase the likelihood of PLC. Breast cancer patients with PLC presented better survival with attentive monitoring than those with POM.
Topics: Humans; Female; Lung Neoplasms; Breast Neoplasms; Middle Aged; Survival Analysis; Aged; Adult; Retrospective Studies; Prognosis; Tomography, X-Ray Computed
PubMed: 38494913
DOI: 10.1111/1759-7714.15285 -
Biomedicines Aug 2022Breast adipose tissue (AT) participates in the physiological evolution and remodeling of the mammary gland due to its high plasticity. It is also a favorable...
Breast adipose tissue (AT) participates in the physiological evolution and remodeling of the mammary gland due to its high plasticity. It is also a favorable microenvironment for breast cancer progression. However, information on the properties of human breast adipose progenitor cells (APCs) involved in breast physiology or pathology is scant. We performed differential enzymatic dissociation of human breast AT lobules. We isolated and characterized two populations of APCs. Here we report that these distinct breast APC populations selectively expressed markers suitable for characterization. The population preferentially expressing (MSCA1) showed higher adipogenic potential. The population expressing higher levels of and acquired myofibroblast characteristics upon TGF-β treatment and a myo-cancer-associated fibroblast profile in the presence of breast cancer cells. This population expressed the immune checkpoint CD274 (PD-L1) and facilitated the expansion of breast cancer mammospheres compared with the adipogenic population. Indeed, the breast, as with other fat depots, contains distinct types of APCs with differences in their ability to specialize. This indicates that they were differentially involved in breast remodeling. Their interactions with breast cancer cells revealed differences in the potential for tumor dissemination and estrogen receptor expression, and these differences might be relevant to improve therapies targeting the tumor microenvironment.
PubMed: 36009475
DOI: 10.3390/biomedicines10081928 -
Polish Journal of Pathology : Official... 2018Two middle-aged females presented with a mass located in the lateral quadrant of the breast. Both patients received modified radical surgery for breast cancer,...
Two middle-aged females presented with a mass located in the lateral quadrant of the breast. Both patients received modified radical surgery for breast cancer, radiotherapy, and chemotherapy and have been living without evidence of disease for more than one year. Under the microscope, we observed that the tumour cells were organised in a solid nest-like or leafy distribution and comprised sebaceous gland cells and oval or fusiform cells. The differences between the two cases are as follows: First, the mass in the first case had a mixed echo pattern on ultrasound, whereas that in the second case had a hypoechoic pattern. Pathology revealed the presence of irregular cysts in the first case, which was consistent with the ultrasound features, and microscopy revealed the presence of necrosis in the tumour. Second, the first case was strongly positive for HER-2 expression, but the second case was negative. In contrast, the second case was positive for ER expression, whereas the first case was negative. Third, the second patient had two axillary lymph node metastases, whereas the first patient had none. We analysed the obtained data to derive the following conclusions: breast sebaceous carcinoma typically occurs in middle-aged women. Under the microscope, two types of cells can be observed in a solid nest-like or leafy distribution. One cell population consists of sebaceous gland-like tumour cells, which are mostly located in the centre of the lobules or cell nests. These represent a more differentiated cell type and are rich in vacuolar cytoplasm. The other cell population consists of smaller oval or fusiform non-vacuolar cells, mostly located at the periphery of the lobules or cell nests. These cells are usually undifferentiated and are thus difficult to distinguish from typical ductal carcinoma cells. Breast sebaceous carcinoma has a high rate of positive expression of ER, PR, p53, and EMA and a low rate of positive expression of HER-2 and GCDFP-15. Primary breast sebaceous cancer has the following diagnostic characteristics: sebaceous differentiation in at least 50% of cells in the absence of any evidence of originating in the cutaneous adnexa; features, such as ductal carcinoma differentiation, lobular carcinoma differentiation, and others, which can be found in primary breast sebaceous cancer, distinct from those in skin sebaceous adenocarcinoma; and a typical transitional structure between the cancer tissue and ductal epithelium. Breast sebaceous carcinoma should be distinguished from skin sebaceous adenocarcinoma, lipid-rich carcinoma, apocrine carcinoma, and glycogen-rich clear cell carcinoma, among others. Furthermore, this is a hormone receptor-dependent type of breast cancer that requires comprehensive treatment. Thus, after extensive analysis, we conclude that breast sebaceous carcinoma has low invasiveness and good prognosis.
Topics: Adenocarcinoma, Sebaceous; Breast Neoplasms; Female; Humans; Lymphatic Metastasis; Middle Aged; Sebaceous Gland Neoplasms
PubMed: 30509049
DOI: 10.5114/pjp.2018.79542 -
Breast Cancer Research and Treatment Feb 2018While the role of natural killer (NK) cells in breast cancer therapy has been investigated, little information is known about NK cell function and presence in...
PURPOSE
While the role of natural killer (NK) cells in breast cancer therapy has been investigated, little information is known about NK cell function and presence in nonmalignant and premalignant breast tissue. Here, we investigate and quantify NK cell marker CD56 and activating ligand MICA in breast tissue with benign breast disease.
METHODS
Serial tissue sections from 88 subjects, 44 with benign breast disease (BBD) who remained cancer-free, and 44 with BBD who later developed cancer, were stained with H&E, anti-MICA, and anti-CD56. Up to ten representative lobules were identified on each section. Using digital image analysis, MICA and CD56 densities were determined for each lobule, reported as percent of pixels in the lobule that registered as stained by each antibody. Analyses were performed on a per-subject and per-lobule basis.
RESULTS
Per-subject multivariate analyses showed associations of CD56 and MICA with age: CD56 was increased in older subjects (p = 0.03), while MICA was increased in younger subjects (p = 0.005). Per-lobule analyses showed that CD56 and MICA levels were both decreased in lobules with fibrocystic change, with median levels of CD56 and MICA staining, respectively, at 0.31 and 7.0% in fibrocystic lobules compared to 0.76 and 12.2% in lobules without fibrocystic change (p < 0.001 for each). Among fibrocystic lobules, proliferative/atypical lobules showed significantly lower expression compared to nonproliferative lobules for MICA (p = 0.02) but not for CD56 (p = 0.80).
CONCLUSION
Levels of CD56+ NK cells and activating ligand MICA were decreased in breast lobules with fibrocystic change, and MICA levels showed a significant stepwise decrease with increasing histopathologic abnormality. MICA levels were also significantly decreased in older subjects, who generally have higher risk of developing cancer. These findings advance a model in which MICA promotes cytotoxic activity in CD56+ NK cells to protect against tumorigenesis in breast lobules, and suggest further research is warranted.
Topics: Adult; Aged; Breast; Breast Neoplasms; CD56 Antigen; Female; Histocompatibility Antigens Class I; Humans; Hyperplasia; Killer Cells, Natural; Male; Middle Aged; Neoplasms; Precancerous Conditions
PubMed: 29090365
DOI: 10.1007/s10549-017-4558-0