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The Basic Pathology of Human Breast Cancer

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Abstract

This article illustrates the most common benign and malignant lesions in the breast, and is intended for the biologist working in the area of breast cancer and breast biology, not for the practicing pathologist. The atlas covers benign proliferative lesions, atypical lesions, variants of in situ cancer, the main types of invasive cancers, spindle cell lesions, and examples of vascular and lymphatic spread. Some entities are included to illustrate a point of particular relevance to the biology and histogenesis of the lesions. Some controversial diagnostic areas are considered, along with the relative risk of developing breast cancer associated with some of the proliferative lesions. The content of this atlas should be read in conjunction with the companion article by Howard and Gusterson in this issue. Their article covers the cellular origin of epithelial and stromal tumors and presents a description of some of the common benign proliferative lesions that are considered to be components of the normal spectrum of changes seen at postmortem or in biopsies.

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REFERENCE

  1. J. Peto, N. Collins, R. Barfoot, S. Seal, W. Warren, N. Rahman, D. F. Easton, C. Evans, J. Deacon, and M. R. Stratton (1999). Prevalence of BRCA1 and BRCA2 gene mutations in patients with early-onset breast cancer. J. Natl. Cancer Inst. 91:943–949.

    Google Scholar 

  2. C. Lengauer, K. W. Kinzler, and B. Vogelstein (1998). Genetic instabilities in human cancers. Nature 396:643–649.

    Google Scholar 

  3. S. R. Lakhani, J. Jacquemier, J. P. Sloane, B. A. Gusterson, T. J. Anderson, M. J. van de Vijver, L. M. Farid, D. Venter, A. Antoniou, A. Storfer-Isser, E. Smyth, C. M. Steel, N. Haites, R. J. Scott, D. Goldgar, S. Neuhausen, P. A. Daly, W. Ormiston, R. McManus, S. Scherneck, B. A. Ponder, D. Ford, J. Peto, D. Stoppa-Lyonnet, D. F. Easton, et al. (1998). Multifactorial analysis of differences between sporadic breast cancers and cancers involving BRCA1 and BRCA2 mutations. J. Natl.Cancer Inst. 90:1138–1145.

    Google Scholar 

  4. S. Ramachandra, L. Machin, S. Ashley, P. Monaghan, and B. A. Gusterson (1990). Immunohistochemical distribution of c-erbB-2 in in situ breast carcinoma—A detailed morphological analysis. J. Pathol. 161:7–14.

    Google Scholar 

  5. K. Meissner, A. Riviere, G. Haupt, and T. Loning (1990). Study of neu-protein expression in mammary Paget's disease with and without underlying breast carcinoma and in extramammary Paget's disease. Am. J. Pathol. 137:1305–1309.

    Google Scholar 

  6. T. Crook, S. Crossland, M. R. Crompton, P. Osin, and B. A. Gusterson (1997). p53 mutations in BRCA1-associated familial breast cancer [letter]. Lancet 350:638–639.

    Google Scholar 

  7. T. Crook, L. A. Brooks, S. Crossland, P. Osin, K. T. Barker, J. Waller, E. Philp, P. D. Smith, I. Yulug, J. Peto, G. Parker, M. J. Allday, M. R. Crompton, and B. A. Gusterson (1998). p53 mutation with frequent novel codons but not a mutator phenotype in BRCA1-and BRCA2-associated breast tumours. Oncogene 17:1681–1689.

    Google Scholar 

  8. M. Rudas, R. Neumayer, M. F. Gnant, M. Mittelbock, R. Jakesz, and A. Reiner (1997). p53 protein expression, cell proliferation and steroid hormone receptors in ductal and lobular in situ carcinomas of the breast. Eur. J. Cancer 33:39–44.

    Google Scholar 

  9. A. Maitra, I. I. Wistuba, A. K. Virmani, M. Sakaguchi, I. Park, A. Stucky, S. Milchgrub, D. Gibbons, J. D. Minna, and A. F. Gazdar (1999). Enrichment of epithelial cells for molecular studies. Nature Med. 5:459–463.

    Google Scholar 

  10. K. Schutze and G. Lahr (1998). Identification of expressed genes by laser-mediated manipulation of single cells. NatureBiotechnol. 16:737–742.

    Google Scholar 

  11. D. J. Lockhart, H. Dong, M. C. Byrne, M. T. Follettie, M. V. Gallo, M. S. Chee, M. Mittmann, C. Wang, M. Kobayashi, H. Horton, and E. L. Brown (1996). Expression monitoring by hybridization to high-density oligonucleotide arrays. NatureBiotechnol. 14:1675–1680.

    Google Scholar 

  12. L. Luo, R. C. Salunga, H. Guo, A. Bittner, K. C. Joy, J. E. Galindo, H. Xiao, K. E. Rogers, J. S. Wan, M. R. Jackson, and M. G. Erlander (1999). Gene expression profiles of lasercaptured adjacent neuronal subtypes. Nature Med. 5:117–122.

    Google Scholar 

  13. J. Kononen, L. Bubendorf, A. Kallioniemi, M. Barlund, P. Schraml, S. Leighton, J. Torhorst, M. J. Mihatsch, G. Sauter, and O. P. Kallioniemi (1998). Tissue microarrays for highthroughput molecular profiling of tumor specimens. NatureMed. 4:844–847.

    Google Scholar 

  14. H. Moch, P. Schraml, L. Bubendorf, M. Mirlacher, J. Kononen, T. Gasser, M. J. Mihatsch, O. P. Kallioniemi, and G. Sauter (1999). High-throughput tissue microarray analysis to evaluate genes uncovered by cDNA microarray screening in renal cell carcinoma. Am. J. Pathol. 154:981–986.

    Google Scholar 

  15. Y. J. Lu, P. Osin, S. R. Lakhani, S. Di Palma, B. A. Gusterson, and J. M. Shipley (1998). Comparative genomic hybridization analysis of lobular carcinoma in situ and atypical lobular hyperplasia and potential roles for gains and losses of genetic material in breast neoplasia. Cancer Res. 58:4721–4727.

    Google Scholar 

  16. National Coordinating Group for Breast Screening Pathology (1995). Pathology Reporting in Breast Cancer Screening, National Health Service Breast Screening Programme, Shef-field, U.K.

    Google Scholar 

  17. J. Dixon (1995). ABC of Breast Diseases, BMJ, London.

    Google Scholar 

  18. J. R. Harris (1996). Diseases of the Breast, Lippincott-Raven, Philadelphia.

    Google Scholar 

  19. E. Scanlon (1986). Benign diseases of the breast. In R. Mc-Kenna and G. Murphy (eds.), Fundamentals of Surgical Oncology, Macmillan, New York, pp. 548–556.

    Google Scholar 

  20. J. P. Sloane (1985). Biopsy Pathology of the Breast, Chapman and Hall, London.

    Google Scholar 

  21. M. J. Silverstein (1997). Ductal Carcinoma In Situ of the Breast, Williams & Wilkins, Baltimore.

    Google Scholar 

  22. P. Rosen and H. Oberman (1992). Tumors of the MammaryGland; Armed Forces Institute of Pathology, Washington, D.C.

    Google Scholar 

  23. D. L. Page and T. J. Anderson (1987). Diagnostic Histopathologyof the Breast, Churchill Livingstone, Edinburgh.

    Google Scholar 

  24. J. G. Azzopardi, A. Ahmed, and R. R. Millis (1979). Problemsin Breast Pathology, Saunders, Phildelphia.

    Google Scholar 

  25. S. R. Wellings, H. M. Jensen, and R. G. Marcum (1975). An atlas of subgross pathology of the human breast with special reference to possible precancerous lesions. J. Natl. CancerInst. 55:231–273.

    Google Scholar 

  26. U. Berger, R. Bettelheim, J. L. Mansi, D. Easton, R. C. Coombes, and A. M. Neville (1988). The relationship between micrometastases in the bone marrow, histopathologic features of the primary tumor in breast cancer and prognosis. Am. J.Clin. Pathol. 90:1–6.

    Google Scholar 

  27. B. A. Gusterson, M. J. Warburton, P. Monaghan, C. Foster, P. Edwards, N. Kraft, C. Smith, D. Mitchell, P. S. Rudland, and A. M. Neville (1984). The use of immunohistochemical probes in the study of benign and malignant breast disease. Behring Inst. Mitt. 74:39–48.

    Google Scholar 

  28. E. Borgen, K. Beiske, S. Trachsel, J. M. Nesland, G. Kvalheim, T. K. Herstad, E. Schlichting, H. Qvist, and B. Naume (1998). Immunocytochemical detection of isolated epithelial cells in bone marrow: Non-specific staining and contribution by plasma cells directly reactive to alkaline phosphatase. J. Pathol. 185:427–434.

    Google Scholar 

  29. J. L. Mansi, H. Gogas, J. M. Bliss, J. C. Gazet, U. Berger, and R. C. Coombes (1999). Outcome of primary-breast-cancer patients with micrometastases: A long-term follow-up study. Lancet 54:197–202.

    Google Scholar 

  30. T. J. Yeatman and C. E. Cox (1999). The significance of breast cancer lymph node micrometastases. Surg. Oncol. Clin. NorthAm. 8:481–496, ix.

    Google Scholar 

  31. J. A. Andersen and J. B. Gram (1984). Radial scar in the female breast. A long-term follow-up study of 32 cases. Cancer 53:2557–2560.

    Google Scholar 

  32. W. D. Dupont and D. L. Page (1985). Risk factors for breast cancer in women with proliferative breast disease. N. Engl. J.Med. 312:146–151.

    Google Scholar 

  33. D. Page and D. Dupont (1985). Anatomic markers of human premalignancy and risk of breast cancer. Cancer 66:1326–1335.

    Google Scholar 

  34. R. Lininger and F. Tavassoli (1997). Atypical intraductal hyperplasia of the breast. In M. Silverstein (eds.), Ductal CarcinomaIn Situ of the Breast, Williams & Wilkins, Baltimore, pp. 195–222.

    Google Scholar 

  35. F. A. Tavassoli and H. J. Norris (1990). A comparison of the results of long-term follow-up for atypical intraductal hyperplasia and intraductal hyperplasia of the breast. Cancer 65:518–529.

    Google Scholar 

  36. D. L. Page, R. Vander Zwaag, L. W. Rogers, L. T. Williams, W. E. Walker, and W. H. Hartmann (1978). Relation between component parts of fibrocystic disease complex and breast cancer. J. Natl. Cancer Inst. 61:1055–1063.

    Google Scholar 

  37. D. L. Page, W. D. Dupont, L. W. Rogers, and M. S. Rados (1985). Atypical hyperplastic lesions of the female breast. A long-term follow-up study. Cancer 55:2698–2708.

    Google Scholar 

  38. W. D. Dupont, F. F. Parl, W. H. Hartmann, L. A. Brinton, A. C. Winfield, J. A. Worrell, P. A. Schuyler, and W. D. Plummer (1993). Breast cancer risk associated with proliferative breast disease and atypical hyperplasia. Cancer 71:1258–1265.

    Google Scholar 

  39. S. J. Schnitt, J. L. Connolly, F. A. Tavassoli, R. E. Fechner, R. L. Kempson, R. Gelman, and D. L. Page (1992). Interobserver reproducibility in the diagnosis of ductal proliferative breast lesions using standardized criteria. Am. J. Surg. Pathol. 16:1133–1143.

    Google Scholar 

  40. M. D. Lagios (1990). Duct carcinoma in situ. Pathology and treatment. Surg. Clin. North Am. 70:853–871.

    Google Scholar 

  41. M. J. Silverstein, D. N. Poller, J. R. Waisman, W. J. Colburn, A. Barth, E. D. Gierson, B. Lewinsky, P. Gamagami, and D. J. Slamon (1995). Prognostic classification of breast ductal carcinoma-in-situ. Lancet 345:1154–1157.

    Google Scholar 

  42. M. J. Silverstein, M. D. Lagios, P. H. Craig, J. R. Waisman, B. S. Lewinsky, W. J. Colburn, and D. N. Poller (1996). A prognostic index for ductal carcinoma in situ of the breast. Cancer 77:2267–2274.

    Google Scholar 

  43. J. A. van Dongen, R. Holland, J. L. Peterse, I. S. Fentiman, M. D. Lagios, R. R. Millis, and A. Recht (1992). Ductal carcinoma in-situ of the breast; Second EORTC Consensus Meeting. Eur. J. Cancer 28:626–629.

    Google Scholar 

  44. J. Russo, B. A. Gusterson, A. E. Rogers, I. H. Russo, S. R. Wellings, and M. J. van Zwieten (1990). Comparative study of human and rat mammary tumorigenesis. Lab. Invest. 62:244–278.

    Google Scholar 

  45. R. D. Cardiff, M. R. Anver, B. A. Gusterson, L. Hennighausen, R. A. Jensen, M. J. Merino, S. Rehm, J. Russo, F. A. Tavassoli, L. M. Wakefield, J. M. Ward, and J. E. Green (2000). The mammary pathology of genetically engineered mice: The consensus report and recommendations from the Annapolis meeting. Oncogene 19:968–988.

    Google Scholar 

  46. D. N. Poller, M. J. Silverstein, M. Galea, A. P. Locker, C. W. Elston, R. W. Blamey, and I. O. Ellis (1994). Ideas in pathology. Ductal carcinoma in situ of the breast: A proposal for a new simplified histological classification association between cellular proliferation and c-erbB-2 protein expression. Mod.Pathol. 7:257–262.

    Google Scholar 

  47. C. A. Bodian, K. H. Perzin, and R. Lattes (1996). Lobular neoplasia. Long term risk of breast cancer and relation to other factors. Cancer 78:1024–1034.

    Google Scholar 

  48. C. D. Haagensen, N. Lane, R. Lattes, and C. Bodian (1978). Lobular neoplasia (so-called lobular carcinoma in situ) of the breast. Cancer 42:737–769.

    Google Scholar 

  49. H. Bloom and W. Richardson (1957). Study of 1,409 cases of which 359 have been followed for 15 years. Br. J. Cancer 11:359–377.

    Google Scholar 

  50. I. O. Ellis, M. Galea, N. Broughton, A. Locker, R. W. Blamey, and C. W. Elston (1992). Pathological prognostic factors in breast cancer. II. Histological type. Relationship with survival in a large study with long-term follow-up. Histopathology 20:479–489.

    Google Scholar 

  51. C. W. Elston and I. O. Ellis (1991). Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: Experience from a large study with long-term follow-up. Histopathology 19:403–410.

    Google Scholar 

  52. J. P. Sloane, I. Amendoeira, N. Apostolikas, J. P. Bellocq, S. Bianchi, W. Boecker, G. Bussolati, D. Coleman, C. E. Connolly, V. Eusebi, C. De Miguel, P. Dervan, R. Drijkoningen, C. W. Elston, D. Faverly, A. Gad, J. Jacquemier, M. Lacerda, J. Martinez-Penuela, C. Munt, J. L. Peterse, F. Rank, M. Sylvan, V. Tsakraklides, and B. Zafrani (1999). Consistency achieved by 23 European pathologists from 12 countries in diagnosing breast disease and reporting prognostic features of carcinomas. European Commission Working Group on Breast Screening Pathology. Virchows Arch. 434:3–10.

    Google Scholar 

  53. H. Pereira, S. E. Pinder, D. M. Sibbering, M. H. Galea, C. W. Elston, R. W. Blamey, J. F. Robertson, and I. O. Ellis (1995). Pathological prognostic factors in breast cancer. IV: Should you be a typer or a grader? A comparative study of two histological prognostic features in operable breast carcinoma. Histopathology 27:219–226.

    Google Scholar 

  54. D. DiCostanzo, P. P. Rosen, I. Gareen, S. Franklin, and M. Lesser (1990). Prognosis in infiltrating lobular carcinoma. An analysis of “classical” and variant tumors. Am. J. Surg. Pathol. 14:12–23.

    Google Scholar 

  55. J. M. Dixon, T. J. Anderson, D. L. Page, D. Lee, and S. W. Duffy (1982). Infiltrating lobular carcinoma of the breast. Histopathology 6:149–161.

    Google Scholar 

  56. P. H. Deos and H. J. Norris (1982). Well-differentiated (tubular) carcinoma of the breast. A clinicopathologic study of 145 pure and mixed cases. Am. J. Clin. Pathol. 78:1–7.

    Google Scholar 

  57. A. D. Abati, M. Kimmel, and P. P. Rosen (1990). Apocrine mammary carcinoma. A clinicopathologic study of 72 cases. Am. J. Clin. Pathol. 94:371–377.

    Google Scholar 

  58. G. N. Peters and M. Wolff (1983). Adenoid cystic carcinoma of the breast. Report of 11 new cases: Review of the literature and discussion of biological behavior. Cancer 52:680–686.

    Google Scholar 

  59. M. L. Jensen, H. Kiaer, J. Andersen, V. Jensen, and F. Melsen (1997). Prognostic comparison of three classifications for medullary carcinomas of the breast. Histopathology 30:523–532.

    Google Scholar 

  60. W. C. Pitts, V. A. Rojas, M. J. Gaffey, R. V. Rouse, J. Esteban, H. F. Frierson, R. L. Kempson, and L. M. Weiss (1991). Carcinomas with metaplasia and sarcomas of the breast. Am. J.Clin. Pathol. 95:623–632.

    Google Scholar 

  61. S. A. Rasbridge and R. R. Millis (1998). Adenomyoepithelioma of the breast with malignant features. Virchows Arch. 432:123–130.

    Google Scholar 

  62. C. J. Moffat, S. E. Pinder, A. R. Dixon, C. W. Elston, R. W. Blamey, and I. O. Ellis (1995). Phyllodes tumours of the breast: A clinicopathological review of thirty-two cases. Histopathology 27:205–218.

    Google Scholar 

  63. J. Rosai. (1991). Borderline epithelial lesions of the breast. Am. J. Surg. Pathol. 15:209–221.

    Google Scholar 

  64. Association of Directors of Anatomic and Surgical Pathology (1996). Recommendations for the reporting of breast carcinoma. Hum. Pathol. 27:220–224.

    Google Scholar 

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Authors and Affiliations

  1. Western Infirmary, Dumbarton Road, Glasgow, G11 6NT, U.K.

    Elizabeth Mallon & Barry Gusterson

  2. The Toby Robins Breakthrough Cancer Research Centre, Section of Cell Biology and Experimental Pathology, Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, U.K.

    Pinchas Osin, Iain Blain & Beatrice Howard

  3. Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, U.K.

    Nasar Nasiri

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  1. Elizabeth Mallon
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Mallon, E., Osin, P., Nasiri, N. et al. The Basic Pathology of Human Breast Cancer. J Mammary Gland Biol Neoplasia 5, 139–163 (2000). https://doi.org/10.1023/A:1026439204849

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