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PubMed1992

Localization of transforming growth factor-beta isotypes in lesions of the human breast.

Transforming growth factor-beta s (TGF-beta) comprise a highly conserved family of multifunctional cell regulatory peptides that may play a role in a variety of pathologic processes. To date, five TGF-beta isotypes have been identified, three of these in mammalian systems. A number of cultured human breast carcinoma cell lines produce biologically inactive latent TGF-beta and are growth inhibited by activated TGF-beta; TGF-beta production is estrogen-influenced in some of these cell lines. To investigate the potential role of the TGF-beta isotypes in human breast disease, we localized TGF-beta s 1, 2, and 3 immunohistochemically in normal breast, fibrocystic change, epithelial hyperplasia, sclerosing adenosis, fibroadenoma, cystosarcoma phyllodes, and several carcinoma variants. Transforming growth factor-beta s 1, 2, and 3 were identified intracellularly in most active mammary epithelia, regardless of the lesion, including carcinoma; the associated stroma contained little or no intracellular TGF-beta. An antibody that recognizes an extracellular conformation of TGF-beta stained normal intralobular stroma and, more extensively, the stroma of active fibroadenomas and low-grade phyllodes tumors and the desmoplastic stroma of carcinomas. The results indicate the potential for paracrine and autocrine regulation of the mammary gland by TGF-beta and suggest an association between TGF-beta and abnormal stromal proliferations. Altered expression of TGF-beta s 1, 2, and 3 at the protein level in mammary epithelia appears not to be a major feature of most breast lesions, raising the possibility that altered cellular response to the TGF-beta already present may play a role in the development of breast disease.

Breast↗

PubMed2006

Breast disorders in children and adolescents.

Concerns about problems of the breast are often noted in adolescents and their parents. This review discusses issues and disorders of the breast in children and adolescents, starting with basic principles of embryology and adolescent breast development. Concepts that are covered include congenital breast disorders, abnormal timing of breast development, breast asymmetry, underdeveloped breasts, breast atrophy, tuberous breasts, mammary hyperplasia, fibroadenoma, giant fibroadenoma, cystosarcoma phyllodes, intra-ductal breast papilloma, adenocarcinoma, mastitis, traumatic breast disorders, benign breast disease, fibrocystic change, mastalgia, gynecomastia, and galactorrhea. A number of figures are provided illustrating breast pathologic findings. Clinicians caring for children and adolescents are encouraged to provide careful assessments of this important organ.

Adolescent↗

PubMed1984

Squamous cell carcinoma of the breast: a clinicopathologic analysis of eight cases and review of the literature.

Malignant neoplasms of the female breast composed of squamous cells are rare and constitute a particularly poorly understood facet of breast disease. Two pure squamous cell carcinomas ( SCCs ) of the breast and six tumors that displayed various combinations of malignant squamous elements and ductal breast adenocarcinoma were identified. Electron microscopy confirmed the diagnosis of SCC in two cases by the demonstration of regularly spaced desmosomes, tonofilament bundles, and keratohyaline granules. A review of the literature indicated that breast cancers with components of SCC are histologically variable. Approximately 30 cases of pure SCC and 80 cases of mixed adenocarcinoma and SCC (adeno-SCC) have been reported. Some of these squamous epithelium-containing tumors have displayed areas of cyst formation, spindle cell metaplasia, and pseudosarcomatous desmoplastic response, or origins in preexisting breast lesions, such as cystosarcoma phyllodes or dermoid cysts. Although this variability indicates a heterogeneous group of neoplasms, the overall prognosis for carcinomas of the breast with malignant squamous elements appears to be quite similar to that for ordinary breast adenocarcinomas of similar size and stage.

Adult↗

PubMed1982

Self-detection of a breast mass in adolescent females.

The frequency of self-discovered breast masses in adolescent females has not previously been described. The histologic diagnosis rather than the means of detection has been the focus of previous surveys. Seven characteristics of 95 patients admitted from 1968-1979 for the evaluation of a breast mass were delineated. The mean age at hospitalization was 15.9 years (range 12-20). The delay from detection to hospitalization was 7.2 months (range 0.5-72). In 77 cases the mass was detected by the patient; 11 were found during a physician examination, 4 by a family member, and 3 by an unrecorded source. Diagnoses were fibroadenoma (71), abscess (11), cyst (9), lipoma (2), and cystosarcoma phyllodes (2). The median length of the masses was 2.6 cm, width 2.3 cm, with a median mass area (diameter x length) of 6 cm2. When patients were compared for age, delay in hospitalization, means of detection, family history, and mass size, the girls with abscesses were younger and had a shorter time delay before hospitalization. Self-discovery was the means of detection in 77 of 95 (81%). The means of detection is an important factor to consider in weighing the merits of teaching breast self-examination procedures to adolescent females.

Abscess↗

PubMed2000

An analysis of 78 breast sarcoma patients without distant metastases at presentation.

PURPOSE: A retrospective review of a single cancer center experience was undertaken to identify clinical or treatment prognostic factors for these unusual tumors, to allow for a recommendation regarding management. METHODS AND MATERIALS: The charts of 76 women and 2 men with breast sarcoma and without distant metastases at presentation registered from 1958 to 1990 were reviewed. Pathology was centrally reviewed in 54 cases. Histology, tumor size, grade, nodal status, age, menopausal status, history of benign breast disease, extent of surgery, resection margins, and radiation dose were each examined as potential prognostic factors by univariate analysis. To allow an analysis of radiation dose, total dose was normalized to a daily fraction size of 2 Gy. RESULTS: The median age at diagnosis was 50.5 years (13-82 years). The pathologic diagnosis was found to be malignant cystosarcoma phyllodes in 32 patients, with the remainder being stromal sarcoma (14), angiosarcoma (8), fibrosarcoma (7), carcinosarcoma (5), liposarcoma (4), other (8). Eighteen patients had grade I or II tumors, 43 had grade III or IV, and 18 were not evaluable. The 5- and 10-year actuarial rates for all 78 patients were 57% and 48% for cause-specific survival (CSS), and 47% and 42% for the relapse-free rates (RFR), respectively. The local relapse-free rate (LRFR) was 75% at both 5 and 10 years. The 5-year CSS for grade I or II tumors was 84% versus 55% for grade III or IV tumors (p = 0.01). Conservative surgery versus mastectomy did not lead to statistically significant different outcomes for CSS, RFR, or LRFR. The comparison of positive versus negative margins showed a 5-year LRFR of 33% versus 80% (p = 0.009). Pairwise comparisons of the 5-year CSS of 91% for > 48 Gy versus either 50% for < or = 48 Gy or 50% for no radiation showed p-values of 0.03 and 0.06, respectively. CONCLUSION: The authors propose that if negative surgical margins can be achieved, breast sarcoma should be managed by conservative surgery with postoperative irradiation to a microscopic tumoricidal dose (50 Gy) to the whole beast, and at least 60 Gy to the tumor bed. The decision to treat should be preceded by a preoperative multidisciplinary assessment. It is also recommended that an axillary lymph node dissection is not indicated, with the possible exception of patients with carcinosarcoma.

Adolescent↗

PubMed1977

Atypical stromal hyperplasia of the prostate gland.

Hyperplastic lesions of the prostatic stroma with atypical changes are presented and discussed. One lesion was a leiomyoma with atypical organization and a limited area of nuclear pleomorphism without mitotic figures. One was a lesion which in many portions was histologically indistinguishable from leiomyosarcoma. It, however, had certain features probably connoting less sinister behavior, and at autopsy 16 months after resection there was no evidence of recurrence or metastasis. One lesion histologically resembled fibroadenoma of the female breast. These three lesions occurred in patients more than 50 years who had symptoms and signs of prostatism. Reference is made to two previously reported lesions reminiscent of cystosarcoma phyllodes of the female breast. All the lesions were located in the craniad prostate, which is estrogen-influenced. A parallel is drawn between these atypical changes in prostatic fibromuscular stroma and atypical changes in the connective tissue stroma of the female breast.

Adenofibroma↗

PubMed1998

F-18 FDG whole-body positron emission tomography scan in primary breast sarcoma.

Three patients with primary breast sarcoma showed intense F-18 FDG breast uptake on the whole-body scan. In two patients the uptake was irregular and associated with cold foci that corresponded to hypodense lesions noted on the chest CT; these represented areas of pathologically demonstrated tumor necrosis. There was also intense FDG uptake in pulmonary, axillary, and supraclavicular lymph node metastases. All lesions were confirmed by CT scan of the chest. Thus F-18 FDG positron emission tomographic scanning accurately staged the tumors in these two patients, and it documented local recurrence in the third patient. Histopathologic examination showed evidence of a high-grade sarcoma, a primary rhabdomyosarcoma, and a malignant cystosarcoma phyllodes of the breast. Similar to breast carcinoma, F-18 FDG whole-body positron emission tomographic imaging could be useful in diagnosing and staging primary breast sarcomas.

Adolescent↗

PubMed1986

Unilateral breast enlargement due to localized fibrosis.

Unilateral breast enlargement in female adolescents is well documented, and is usually associated with fibroadenoma, cystosarcoma phyllodes, or virginal hypertrophy. We have described a rare instance of breast enlargement related to fibrosis. Whether or not this lesion is related to hormonal changes, as the other three entities are thought to be, or to trauma and associated necrosis is only speculative.

Adult↗

PubMed1989

Fibroadenoma of the breast: sonographic appearance.

The sonographic patterns of 100 fibroadenomas, including two giant fibroadenomas and two cystosarcoma phyllodes, were reviewed. The lesions were mostly hypoechoic (92%) and homogeneous in echotexture (72%). Twenty-seven percent of fibroadenomas showed irregular margins. Intratumoral calcifications were noted in 10% of lesions. A marked acoustic shadow without associated calcification was seen in six cases. The mean ratio of the length to the anteroposterior diameter of the tumors was 1.84 +/- 0.52 (standard deviation), indicating an elongation along the general orientation of the breast tissue planes. The ratios of length to anteroposterior diameter calculated in two matching groups of small (less than 1 cm3) fibroadenomas and carcinomas differed significantly. State-of-the-art high-frequency transducers, geometric analysis of tumors, and real-time ultrasound-guided fine-needle aspiration biopsy should help to distinguish between benign and malignant solid breast masses.

Adenofibroma↗

PubMed1979

Mammary hamartomas.

Five cases of mammary hamartoma are described, with special reference to the radiographic features. Hamartomas are well circumscribed lesions composed of normal or dysplastic mammary tissue. They are probably more common than has been anticipated from the literature and are important because they may be confused with other well circumscribed tumors, such as cystosarcoma phyllodes. The radiographic characteristics of hamartoma allows a tentative diagnosis in most cases.

Adult↗

PubMed1999

Pathology of the breast in children, adolescents, and young adults.

The pathologic spectrum of breast disease in children and adolescents is broad and includes entities more commonly seen in older patients. In general, the vast majority of breast masses in young patients are benign with fibroadenomas, gynecomastia, and macromastia accounting for the majority of surgical specimens. Malignant tumors are more likely to be secondary or metastatic than primary. Rhabdomyosarcoma and hematolymphoid tumors comprise a majority of malignant diagnoses in children. Primary carcinomas and sarcomas are rare, especially if sarcomas arising in the setting of cystosarcoma phyllodes are excluded.

Adenoma↗

PubMed2001

[Breast chondrosarcoma: a case report and review].

Sarcomas of the breast are relatively rare and account for 1% of all primary malignant tumors of the breast. Only 4 cases of pure chondrosarcoma of the breast have been published. We report an additional case in a fifty-seven-year-old woman. Histological and immunohistological characteristics were similar to those described in other localizations. Differential diagnosis involves cystosarcoma phyllodes and breast metaplastic carcinoma with chondroid differentiation. The prognosis is likely to be the same as in other chondrosarcomas.

Breast Neoplasms↗

PubMedDate not supplied

[Giant fibroadenoma of the breast in an adolescent: a case report].

The authors report a case of giant fibroadenoma of the breast in a girl of 11 years old. Juvenile or giant fibroadenoma is a rare pathology usually presenting in adolescence, characterized by massive and rapid enlargement of an encapsulated mass. Nowadays there are some preoperative difficulties distinguishing it from cystosarcoma phyllodes which has a benign and malignant form. It is important to differentiate the two pathologies before operation as they have a different therapeutic approach and different follow up. The etiology is believed to be an end-organ hypersensitivity to normal levels of gonadal hormones and the age of presentation is between 10 to 18 years old. Treatment is usually surgical and ranges from simple excision to subcutaneous mastectomy with reconstruction.

Breast Neoplasms↗

PubMed1992

Lectin binding patterns in benign and malignant lesions of the breast.

The binding patterns of a panel of eight lectins were studied in twenty eight breast lesions, consisting of ten cases of fibroadenoma, three cases of cystosarcoma phyllodes, five cases of fibrocystic disease and ten cases of infiltrating duct carcinoma by light microscopy. The eight lectins viz. PNA, WGA, RCA, SBA, UEA I, LTA, LCA and Con A were tested on paraffin sections using the Avidin Biotin Peroxidase Complex technique. PNA, RCA and UEA I showed a consistent positivity in benign and malignant lesions. The binding was localised mainly along the apices of mammary ductal epithelial cells in the benign lesions. In contrast, the malignant cells showed a considerable variation in staining patterns like diffuse cytoplasmic, membranous, and vacuolar. No definite correlation was seen between the intensity of binding and the histological grade in infiltrating duct carcinoma except in the case of Con A which was seen to bind more intensely to poorly differentiated tumours. The diagnostic significance of these patterns have been discussed.

Breast Neoplasms↗

PubMedDate not supplied

Primary chondrosarcoma of the breast: a case report.

Mammary sarcomas are uncommon tumors. Of these pure chondrosarcoma without any other area of epithelial or mesenchymal differentiation feature as even rarer. This excludes tumors like malignant cystosarcoma phyllodes and metaplastic carcinoma where malignant cartilaginous areas may be present. Further primary chondrosarcoma arises from breast stroma and not from underlying bone or cartilage. Only five cases of pure and primary chondrosarcoma have been reported so far. The sixth case is reported here.

Breast Neoplasms↗

PubMed1991

Carcinoembryonic antigen and alpha-lactalbumin in phylloid tumor tissues.

The concentration of carcinoembryonic antigen and alpha-lactalbumin in tumor tissue cytosol were analyzed in a group of 19 tumors of cystosarcoma phyllodes type. Both antigens were also localized in the tissue of identical tumors by means of immunohistochemical procedure. The cytosol levels of both proteins were found to be higher in the histologically defined malignant type of phylloid tumors. This group was also characterized by the simultaneous occurrence of both antigens. We did not manage to prove any relationship between the presence of alpha-lactalbumin and the steroid hormone receptor positivity in tumor tissue.

Breast Neoplasms↗

PubMed1975

[Histological classification of malignant breast neoplasms. Recent concepts].

The recent histological classifications of breast malignant epithelial tumours place increased emphasis on several concepts: in situ carcinoma, difference of lobular carcinoma from other forms of breast cancer and histological factors of prognosis. The authors propose to discriminate: non infiltrating duct carcinoma (intraductal carcinoma); lobular carcinoma (in situ and infiltrating); infiltrating duct carcinoma in their usual form (80 p. 100 about of all breast carcinoma); among them, histological types with a less ominous prognosis, although relatively rare, are stressed (infiltrating papillary and comedo-carcinomas, tubular carcinoma, medullary carcinoma, colloid carcinoma, cylindroma, certain metaplastic variants, Paget's disease of the nipple); some features in unusual hosts are related. They mention the criteria of the Scarff and Bloom's "grading" and its importance from the point of view of prognosis, mainly for the usual infiltrating forms. Other malignant tumours of the breast (malignant cystosarcoma phyllodes, sarcomas, mammary metastases) are more scarcely seen (I p. 100 of the mammary neoplasms): their classification is succinctly recalled.

Breast↗

PubMed1979

Immunological cross reaction between sera from patients with breast cancer and mouse mammary tumor virus.

Sera of Japanese women with breast cancer and without disorders of the mammary gland gave positive immunofluorescence reaction with mouse mammary tumor cells (MMT cells) producing type-A and type-B virus particles. Among these, 55.1% (49/89) of the sera from patients with breast cancer reacted with MMT cells, whereas 60% (3/5) of the sera from patients with benign mammary hyperplasia (2 of 3 mastopathies, 1 of 2 cystosarcoma phyllodes), 30% (12/40) of the patients with other than breast cancer (4 of 14 stomach cancers, 6 of 20 uterine cancers, 1 of 3 lung cancers, 1 of 3 rectum cancers), and 26.5% (18/68) of the sera from apparently healthy women showed positive reaction with MMT cells. Distribution pattern of the specific fluorescence obtained with positive human sera was similar to that resulting from the reaction with rabbit antiserum of type-A particles. Results of absorption studies and blocking tests also suggested that the reaction was due to the antigenic components common to type-A and -B particles. Furthermore, the results of membrane immunofluorescence tests suggested that some human sera also react with envelope antigen(s) of B particles. Antinuclear antibody was found in sera from 15.7% (14/89) of breast cancer patients by the indirect immunofluorescence tests, and antibody cross-reacting with mouse mammary tumor virus was not found in most of the sera from breast cancer patients who have antinuclear antibody.

Adenocarcinoma↗