Subgross Physiopathology of the Breast Associated with Clinical Cancer 1

Abstract

Italian

Fifty human breasts removed for cancer by radical mastectomy were submitted to subgross analysis of the glandular tree as a whole, stained thin sections (2 mm) under a dissection microscope, followed by histologic study of the lesions found. The glandular tree was more often atrophic (70%) than hyperplastic (30%). The frequencies of physiopathologic changes were as follows: ductal papilloma (4%), ductal hyperplasia (6%), fibroadenoma (16%), sclerosing adenosis (24%), cysts (28%), apocrine cysts (18%), cystic ducts (40%), blind terminal ducts (60%), atrophic lobules (88%), sclerotic lobules (34%), hyperplastic lobules (28 %), cystic lobules (52%), persistent lobules in otherwise atrophic breasts (30%), lobules with apocrine metaplasia (30%), atypical lobules with proliferative changes (38 %), and independent foci of microscopic cancer (20%). The data indicate: 1) a frequent lack of correlation between ovarian function (menstrual cycles, menopause) and type of mammary glandular tree (hyperplastic, atrophic); 2) a rarity of ductal lesions compared with the frequency of lobular lesions; 3) a ubiquitous distribution of the lesions either near or far from clinical cancer; 4) a significant association of atypical lobules with lobular sclerosis (p < 0.001) and apocrine metaplasia (p < 0.05). The frequency and ubiquity of lobular changes suggest further investigation among them to search for suitable candidates as preneoplastic or predictive lesions.

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References

Bern

H.A.

, De Ome

K.B.

, Alfert

, Pitelka

D.R.

: Morphologic and physiologic characterization of hyperplastic nodules in the mammary gland of the C3H/He Crgl mouse. In: Proceedings of the II International Symposium on Mammary Cancer, pp. 569–573, Severi

(ed.), Division of Cancer Research, Perugia, 1958.

Bonser

G.M.

: A microscopical study of the evolution of mouse mammary cancer: The effect of the milk factor and a comparison with the human disease. J. Pathol. Bacteriol., 57: 413–422, 1945.

Brennan

M.J.

: Endocrinology in cancer of the breast; status and prospects. Am. J. Clin. Pathol., 64: 797–802, 1975.

Crile

Jr. : Multicentric breast cancer. The incidence of the new cancers in the homolateral breast after partial mastectomy. Cancer, 35: 475–477, 1975.

De Orne

K.B.

, Nandi

, Bern

H.A.

, Blair

, Pitelka

: The preneoplastic hyperplastic alveolar nodule as the morphological precursor of mammary cancer in mice. In: The Morphological Precursors of Cancer, pp. 349–368, Severi

(ed.), Division of Cancer Research, Perugia, 1962.

Fisher

E.R.

, Gregorio

, Redmond

, Vellios

, Sommers

S.C.

, Fisher

: Pathologic findings from the National Surgical Adjuvant Breast Project (Protocol No. 4). I. Observations concerning multicentricity of mammary cancer. Cancer, 35: 247–253, 1975.

Foulds

: The histologic analysis of mammary tumors of mice. II. The histology of responsiveness and progression. The origins of tumors. J. Nat. Cancer Inst., 17: 713–753, 1956.

Gallagher

H.S.

, Martin

J.E.

: Early phases in the development of breast cancer. Cancer, 24: 1170–1178, 1969.

Haagensen

C.D.

: Diseases of the Breast, 2nd ed., W.B. Saunders, Philadelphia, 1971.

10.

Huseby

B.A.

, Bittner

J.I.

: A comparative morphological study of the mammary glands with reference to the known factors influencing the development of mammary carcinoma in mice. Cancer Res., 6: 240–255, 1946.

11.

Ingleby

, Holly

: A method for the preparation of serial slices of the breast. Bull. Int. Assoc. Med. Museum, 19: 93–96, 1939.

12.

Marcum

R.G.

, Wellings

S.R.

: Subgross pathology of the human breast: Method and initial observations. J. Nat. Cancer Inst., 42: 115–121, 1969.

13.

McDivitt

R.W.

, Stewart

F.W.

, Berg

J.W.

: Tumors of the breast. In: Atlas of Tumors Pathology, Second series, Fasc. 3, Armed Forces Institute of Pathology, Washington, 1968.

14.

Migliori

: Un metodo di studio submacroscopico della mammella umana intera, Tumori, 61: 357–363, 1975.

15.

Nandi

, Bern

H.A.

, De Ome

K.B.

: Effect of hormones on growth and neoplastic development of transplanted hyperplastic alveolar nodules of the mammary gland of C3H/Crgl mice. J. Nat. Cancer Inst., 24: 883–905, 1960.

16.

Parks

A.G.

: The microanatomy of the breasts. Ann. R. Coll. Surg. Engl., 24: 235–251, 1959.

17.

Sarnelli

, Orlandi

, Migliori

, Squartini

: Morfologia submacroscopica della mammella: Reperti semeiologici, nomenclatura e possibilità di applicazione del metodo. Pathologica, 72: 139–187, 1980.

18.

Sinha

, Dao

T.L.

: A direct mechanism of mammary carcinogenesis induced by 7,12-dimethylbenz(a)anthracene. J. Nat. Cancer Inst., 53: 841–846, 1974.

19.

Sinha

, Dao

T.L.

: Site of origin of mammary tumors induced by 7,12-dimethylbenz(a)anthracene in the rat. I. Nat. Cancer Inst., 54: 1007–1009, 1975.

20.

Squartini

: Epoca di insorgenza, caratteri e comportamento dei noduli di iperplasia alveolare della mammella del topo. Lav. Ist. Anat. Istol. Patol. Perugia, 15: 139–152, 1955.

21.

Squartini

, Caschera

: Sviluppo mammario, noduli di iperplasia alveolare e tumori nei topi femmina vergini BALB/cf. Lav. Ist. Anat. Istol. Patol. Perugia, 18: 175–204, 1958.

22.

Squartini

: Mammogenesis and breast carcinogenesis in virgin female mice of BALB/cf substrain with the milk agent. J. Nat. Cancer Inst., 23: 1227–1238, 1959.

23.

Squartini

: Mammary tumors in mice as a model in studies on carcinogenesis. In: Recent Contributions to Cancer Research in Italy, pp. 289–335, Bucalossi

, e Veronesi

(eds.), Casa Editrice Ambrosiana, Milano, 1960.

24.

Squartini

, Rossi

: Responsiveness and progression of the morphological precursors of breast cancer in inbred mice: A review. In: The Morphological Precursors of Cancer, pp. 319–327. Severi

(ed.), Division of Cancer Research, Perugia, 1962.

25.

Squartini

, Severi

: Strain differences in the mammary tumour-inducing virus as detected by the character and behaviour of neoplasms. In: A Ciba Foundation Symposium on Tumour Viruses of Murine Origin, pp. 82–103. Wolstenholme

G.E.W.

, and O'Connor

(eds.), J. and A. Churchill, London, 1962.

26.

Squartini

: III. Histogenesis. In: Breast Cancer Research. UICC Technical Report Series, Vol. 27, pp. 51–55. Brennan

M.I.

(ed.), International Union Against Cancer, Geneva, 1977.

27.

Tanaka

, Oota

: A stereomicroscopic study of the mastopathic human breast. I. Threedimensional structures of abnormal duct evolution and their histologic entity. Virchows Arch. (Pathol. Anat.), 349: 195–214, 1970.

28.

Turner

C.W.

, Gomez

E.T.

: The normal development of the mammary gland of the male and female albino mice. I. Intrauterine. II. Extrauterine. Mo. Agr. Exp. Res. Bull., 182: 1–43, 1932.

29.

Wellings

S.R.

, Jensen

H.M.

: On the origin and progression of ductal carcinoma in the human breast. J. Nat. Cancer Inst., 50: 1111–1118, 1973.

30.

Wellings

S.R.

, Jensen

H.M.

, Marcum

R.G.

: An atlas of subgross pathology of the human breast with special reference to possible precancerous lesions. J. Nat. Cancer Inst., 55: 231–273, 1975.

31.

Wellings

S.R.

, Rice

I.D.

: Preneoplastic lesions in the human breast. In: Cancer Compaign. Early Diagnosis of Breast Cancer, Vol. 1, pp. 91–106, Grundmann

, e Beck

(eds.), Gustav Fisher Verlag, Stuttgart, New York, 1978.