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Techniques in Vascular and... Mar 2014Normal breast anatomy can be seen on a variety of imaging modalities. Knowledge of normal breast anatomy on imaging examinations is important for an interventionalist,... (Review)
Review
Normal breast anatomy can be seen on a variety of imaging modalities. Knowledge of normal breast anatomy on imaging examinations is important for an interventionalist, primarily to avoid mistaking normal anatomy for a pathologic disorder, so as not to harm a patient with an unnecessary intervention. Knowledge of breast anatomy is also critical in planning safe breast interventions and unwanted procedural complications. The key anatomical structures in the breast include skin, fat, fascial layers, Cooper ligaments, fibroglandular tissue, lymphatics, and neurovascular structures, all positioned over the chest wall. In men, the breast parenchyma is usually only composed of fat, with absence of fibroglandular tissue. In women, fibroglandular tissue volumes vary with age, with many women having a predominance of fat within the breasts after menopause. Embryologically, the breast develops under genetic and hormonal influence from skin precursor cells during the fourth through twelfth weeks of gestation, and the resulting breast bud continues to lengthen and branch throughout the remainder of gestation, forming a complex network of radially arranged breast ducts that connect the nipple with the mammary lobules. The key arterial blood supply to the breast arises from the internal thoracic artery, but additional arterial blood supply is seen from intercostal and lateral thoracic arteries. The venous anatomy and lymphatic drainage of the breast generally parallels the arterial anatomy, with presence of variation in communicating channels between deep and superficial venous and lymphatic channels. Tools that assess breast vascular structures (eg, contrast-enhanced breast magnetic resonance imaging) and lymphatic structures (nuclear medicine lymphoscintigraphy) are routinely used to assess extent of breast disease and help guide breast interventions.
Topics: Breast; Female; Humans; Mammography; Models, Anatomic; Radiography, Interventional; Surgery, Computer-Assisted
PubMed: 24636325
DOI: 10.1053/j.tvir.2013.12.002 -
Nature Aug 2023The adult human breast is comprised of an intricate network of epithelial ducts and lobules that are embedded in connective and adipose tissue. Although most previous...
The adult human breast is comprised of an intricate network of epithelial ducts and lobules that are embedded in connective and adipose tissue. Although most previous studies have focused on the breast epithelial system, many of the non-epithelial cell types remain understudied. Here we constructed the comprehensive Human Breast Cell Atlas (HBCA) at single-cell and spatial resolution. Our single-cell transcriptomics study profiled 714,331 cells from 126 women, and 117,346 nuclei from 20 women, identifying 12 major cell types and 58 biological cell states. These data reveal abundant perivascular, endothelial and immune cell populations, and highly diverse luminal epithelial cell states. Spatial mapping using four different technologies revealed an unexpectedly rich ecosystem of tissue-resident immune cells, as well as distinct molecular differences between ductal and lobular regions. Collectively, these data provide a reference of the adult normal breast tissue for studying mammary biology and diseases such as breast cancer.
Topics: Adult; Female; Humans; Breast; Breast Neoplasms; Endothelial Cells; Epithelial Cells; Gene Expression Profiling; Genomics; Single-Cell Analysis; Immunity
PubMed: 37380767
DOI: 10.1038/s41586-023-06252-9 -
Clinical Breast Cancer Feb 2021Immune cells are present in normal breast tissue and in breast carcinoma. The nature and distribution of the immune cell subtypes in these tissues are reviewed to... (Review)
Review
Immune cells are present in normal breast tissue and in breast carcinoma. The nature and distribution of the immune cell subtypes in these tissues are reviewed to promote a better understanding of their important role in breast cancer prevention and treatment. We conducted a review of the literature to define the type, location, distribution, and role of immune cells in normal breast tissue and in in situ and invasive breast cancer. Immune cells in normal breast tissue are located predominantly within the epithelial component in breast ductal lobules. Immune cell subtypes representing innate immunity (NK, CD68, and CD11c cells) and adaptive immunity (most commonly CD8, but CD4 and CD20 as well) are present; CD8 cells are the most common subtype and are primarily effector memory cells. Immune cells may recognize neoantigens and endogenous and exogenous ligands and may serve in chronic inflammation and immunosurveillance. Progression to breast cancer is characterized by increased immune cell infiltrates in tumor parenchyma and stroma, including CD4 and CD8 granzyme B cytotoxic T cells, B cells, macrophages and dendritic cells. Tumor-infiltrating lymphocytes in breast cancer may serve as prognostic indicators for response to chemotherapy and for survival. Experimental strategies of adoptive transfer of breast tumor-infiltrating lymphocyte may allow regression of metastatic breast cancer and encourage development of innovative T-cell strategies for the immunotherapy of breast cancer. In conclusion, immune cells in breast tissues play an important role throughout breast carcinogenesis. An understanding of these roles has important implications for the prevention and the treatment of breast cancer.
Topics: Breast; Breast Neoplasms; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Carcinoma, Ductal, Breast; Female; Humans; Lymphocytes, Tumor-Infiltrating; Tumor Microenvironment
PubMed: 32893093
DOI: 10.1016/j.clbc.2020.06.011 -
The American Surgeon Aug 2022Lymphoma of the breast is a rare diagnosis, accounting for less than 0.5% of all breast malignancies. Presentation is usually similar to that of breast cancer, with a...
Lymphoma of the breast is a rare diagnosis, accounting for less than 0.5% of all breast malignancies. Presentation is usually similar to that of breast cancer, with a painless palpable mass. This report describes a unique case of a 13 cm breast lymphoma. The patient is a 74 year old female who presented to clinic with a right breast mass that has been present since the 1970s. She had previously undergone multiple excisions of lesions on both breasts, always with benign pathology. In 2017, screening mammogram revealed a suspicious lesion in the right upper outer breast with associated axillary lymphadenopathy. She was lost to follow up but presented again after the mass significantly grew in size over several months. Mammography showed a large 13 x 8.7 cm lobulated mass. Biopsy of the lesion revealed diffuse large B-cell lymphoma. Treatment for this patient will begin with chemotherapy.
Topics: Aged; Biopsy; Breast; Breast Neoplasms; Female; Humans; Lymphoma, Large B-Cell, Diffuse; Mammography
PubMed: 35420924
DOI: 10.1177/00031348221084964 -
Journal of Investigative Surgery : the... Mar 2022Idiopathic granulomatous mastitis (IGM) is a rare form of chronic inflammatory breast disease. Although it is a benign breast lesion, it may be sometimes difficult to... (Review)
Review
Idiopathic granulomatous mastitis (IGM) is a rare form of chronic inflammatory breast disease. Although it is a benign breast lesion, it may be sometimes difficult to distinguish from breast cancer. The cause of IGM is unknown, but may be associated with autoimmunity, abnormal hormone levels and infection. While the clinical manifestations of IGM involve various manifestations of inflammation, the diagnosis is principally established by histopathology, characterized by non-caseating granulomas and microabscess formation centered on the breast lobules. Therapeutic options for IGM range from observation to various medical treatments, such as steroids, immunosuppressants, and antibiotics, to surgical intervention, particularly if secondarily infected. Given that the controversy on etiology and treatment choices, we accomplished the present review through reviewing IGM-related literature published in 'Pubmed' and 'Web of science' databases during 1997 to 2020, aiming to provide the basis for rational clinical diagnosis and treatment.
Topics: Breast; Breast Neoplasms; Diagnosis, Differential; Female; Granulomatous Mastitis; Humans; Inflammation
PubMed: 33691563
DOI: 10.1080/08941939.2021.1894516 -
BioRxiv : the Preprint Server For... Apr 2023The adult human breast comprises an intricate network of epithelial ducts and lobules that are embedded in connective and adipose tissue. While previous studies have...
The adult human breast comprises an intricate network of epithelial ducts and lobules that are embedded in connective and adipose tissue. While previous studies have mainly focused on the breast epithelial system, many of the non-epithelial cell types remain understudied. Here, we constructed a comprehensive Human Breast Cell Atlas (HBCA) at single-cell and spatial resolution. Our single-cell transcriptomics data profiled 535,941 cells from 62 women, and 120,024 nuclei from 20 women, identifying 11 major cell types and 53 cell states. These data revealed abundant pericyte, endothelial and immune cell populations, and highly diverse luminal epithelial cell states. Our spatial mapping using three technologies revealed an unexpectedly rich ecosystem of tissue-resident immune cells in the ducts and lobules, as well as distinct molecular differences between ductal and lobular regions. Collectively, these data provide an unprecedented reference of adult normal breast tissue for studying mammary biology and disease states such as breast cancer.
PubMed: 37163043
DOI: 10.1101/2023.04.22.537946 -
Cancer Apr 2009Lobules in normal breast tissue can be classified based on their degree of development, which may affect their susceptibility to carcinogenesis. However, few...
BACKGROUND
Lobules in normal breast tissue can be classified based on their degree of development, which may affect their susceptibility to carcinogenesis. However, few epidemiologic studies to date have addressed this.
METHODS
The authors examined the association between lobule type and subsequent breast cancer risk in a nested case-control study of benign breast disease (BBD) and breast cancer within the Nurses' Health Studies (200 cases, 915 controls). Benign breast biopsy slides were reviewed by pathologists, and normal terminal duct lobular units were classified as having no type 1 lobules, mixed lobule types, or predominant type 1 and no type 3 lobules. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for the association between lobule type and breast cancer risk.
RESULTS
Women with predominant type 1 and no type 3 lobules (54 cases, 321 controls) had a decreased risk of breast cancer compared with those with no type 1 lobules or mixed lobule types (OR=0.63; 95% CI, 0.44-0.91), although this was attenuated after adjustment for histologic category of BBD (OR=0.71; 95% CI, 0.49-1.02). Having predominant type 1 lobules and no type 3 lobules was associated with a similar risk reduction for all categories of BBD (nonproliferative: OR=0.73 [95% CI, 0.36-1.50]; proliferative without atypia: OR=0.80 [95% CI, 0.47-1.35]; and atypical hyperplasia: OR=0.61 [95% CI, 0.28-1.35]).
CONCLUSIONS
These results provided preliminary evidence that lobule type may be an important marker of breast cancer risk in women with BBD.
Topics: Adolescent; Adult; Aged; Biopsy; Breast; Breast Diseases; Breast Neoplasms; Case-Control Studies; Female; Humans; Middle Aged; Precancerous Conditions; Risk
PubMed: 19170235
DOI: 10.1002/cncr.24167 -
Der Pathologe Feb 2009The human breast consists of lobes with a luminal glandular and a basal myoepithelial layer. Immunofluorescence studies have shown that the breast epithelium contains... (Review)
Review
The human breast consists of lobes with a luminal glandular and a basal myoepithelial layer. Immunofluorescence studies have shown that the breast epithelium contains cytokeratin (CK)5/14-positive precursor cells which give rise to CK8/18-positive glandular or sm-actin-positive myoepithelial cells. Only some of the glandular cells contain estrogen receptors. The luminal epithelium of the lobules shows a much higher glandular differentiation than the ductal system. Diagnostically important cytokeratins of normal breast epithelium and its proliferative epithelial processes include luminal cytokeratins (CK7, CK8 and CK18) as markers of glandular differentiation and basal cytokeratins (CK5, CK14 and CK17) as markers of progenitor cells and early cells of the glandular and myoepithelial differentiation pathway. The most important myoepithelial markers are currently CD10, SMA, SMM-HC and Calponin.
Topics: Biomarkers; Breast; Calcium-Binding Proteins; Cell Differentiation; Cell Division; Epithelial Cells; Female; Humans; Keratin-14; Keratin-5; Keratins; Microfilament Proteins; Neprilysin; Regeneration; Calponins
PubMed: 19184024
DOI: 10.1007/s00292-008-1102-3 -
Journal of Cutaneous Pathology Feb 2023Post-radiation angiosarcoma is an iatrogenic event seen in the setting of breast cancer treatment. Histopathologically, there are morphologic variants of angiosarcoma...
AIM
Post-radiation angiosarcoma is an iatrogenic event seen in the setting of breast cancer treatment. Histopathologically, there are morphologic variants of angiosarcoma that mimic benign entities, including the capillary lobule variant of post-radiation angiosarcoma. We present the largest case series to date of this histopathologic variant of post-radiation angiosarcoma.
METHODS AND RESULTS
Cases of the capillary lobule variant of post-radiation angiosarcoma from institutional/consultation archives from 2008 to June 2022 were reviewed. For inclusion, tumors had to occur in irradiated skin and exhibit a multi-lobular proliferation of tightly packed capillary-like vessels, as previously described in this variant. Prior ancillary studies were also reviewed. Eight cases met the criteria. All occurred in women treated with radiation for breast cancer (median age 75 years). All cases had similar findings, including a multi-lobular proliferation of tightly packed vessels, infiltrative cords, and atypical single endothelial cells. A conventional angiosarcoma pattern was also seen in five cases. All cases tested were positive for vascular markers (CD31, CD34, and/or ERG) and MYC. MYC amplification was shown by FISH in all cases tested. Smooth muscle actin (SMA) was positive in pericytes in the capillary lobules in all five cases tested and areas of conventional angiosarcoma in two of three cases.
CONCLUSIONS
The capillary lobule variant of angiosarcoma is a rare and therefore potentially under-recognized variant of post-radiation angiosarcoma. The lobular architecture and SMA positivity may mimic benign vascular proliferations. Careful attention to histopathologic features and ancillary tests may facilitate accurate diagnosis.
Topics: Female; Humans; Hemangiosarcoma; Endothelial Cells; Breast Neoplasms; Skin; Vascular Diseases; Skin Neoplasms
PubMed: 36107728
DOI: 10.1111/cup.14328