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Localisation of Ca and HMFG2 antigens in breast tissue by immunoperoxidase, immunofluorescence, and immunoelectron microscopy.

The reactivities of Ca1 and HMFG2 monoclonal antibodies were compared on paraffin wax embedded breast tissues using indirect immunoperoxidase. The expression of Ca antigen, like HMFG2, is not exclusive to malignancy: Ca was present in 41/53 (77%) and HMFG2 in 42/53 (79.2%) non-malignant conditions and both were present in 33/35 (94%) carcinomas. Similar results were obtained when cryostat sections were used. Both antigens showed striking similarities in their topographical distributions, although quantitative differences were seen. Their cellular and sub-cellular localisations were investigated by double labelling immunofluorescence and immunogold electron microscopy, which showed that the expression of Ca and HMFG2 antigens was closely associated on cell membranes but that the epitopes were distinct.

Adenofibroma↗

Does ovarian sex cord tumour with annular tubules produce progesterone?

Probable progesterone production was identified by an immunoperoxidase assay in a case of an ovarian sex cord tumour with annular tubules. The tumour was associated with a serous cystadenofibroma in the opposite ovary and with adenoma malignum (adenocarcinoma) of the cervix.

Adenocarcinoma↗

Immunohistochemical detection of ras oncogene p21 product in benign and malignant mammary tissue in man.

The monoclonal antibody RAP-5 generated against a synthetic peptide corresponding to amino acid positions 10-17 of the ras p21 protein was used in an immunohistochemical study of the expression of ras in normal, benign, and malignant breast epithelium in man. The staining intensity and intracellular distribution of RAP-5 was similar in the three epithelial populations and extended to other tissue elements including myoepithelial cells, smooth muscle, myelin, capillary endothelium, and stromal fibroblasts, as well as sebaceous glands and sweat glands overlying the breast. These results suggest that RAP-5 recognises a normal cellular component, the expression of which is not more enhanced in hyperplastic or neoplastic conditions. The detection of mutant forms of p21 exclusively expressed in malignant tumours requires that alternative reagents be developed.

Adenofibroma↗

Sarcoidosis of the breast.

Sarcoid granulomata were found incidentally in the mammary lobules adjacent to an excised fibroadenoma in a case of sarcoidosis of the breast. The diagnosis of sarcoidosis was established by the radiological finding of bilateral hilar lymphadenopathy, raised concentrations of serum angiotensin converting enzyme and lysozyme, and, finally, by a positive Kveim test.

Adenofibroma↗

Semiquantitative analyses of fine needle aspirates from benign and malignant breast lesions.

A scoring system for the assessment of fine needle aspirates of benign and malignant breast lesions was devised which showed a positive correlation (r = 0.67) between the scores obtained from the fine needle aspirates from ductal carcinomas and the Bloom and Richardson-type scores for their paired excision biopsy specimens. This system permitted grades II and III ductal breast carcinoma to be distinguished reliably from grade I tumours but no correlation with the lymph node state of patients with breast carcinoma was shown. Some overlap between the scores for grade I ductal carcinomas and some benign lesions was found, and this underlines a need for caution in the reporting of such equivocal aspirates. No cytological features that distinguished reliably ductal from lobular carcinoma were identified but the same spectrum of severity of cytological abnormality in the ductal and lobular carcinoma aspirates was seen. This system may be of prognostic value in the assessment of lobular carcinoma which has hitherto defied histological grading.

Adenofibroma↗

Ultrastructural analysis of fine needle aspirates from benign breast lesions.

Thirty six fine needle aspirates from various types of benign breast lesions were examined by electron microscopy and correlated with their cytological appearances. In all cases the parenchyma consisted of clumps of cohesive cells with the ultrastructural features of epithelial cells. In many cases, particularly from fibroadenomas, the parenchyma consisted of single layers of polarised epithelial cells showing lumen formation. Similar arrays of apocrine epithelial cells were observed in 60% of fibrocystic lesions. The more solid clumps from hyperplastic lesions consisted of epithelial cells of variable shape and electron density with disorganised lumen formation. Irrespective of the type of lesion, the epithelial cells were not normally subtended by myoepithelial cells or basal lamina. The extraction process seems to result in a shearing between the epithelium and basal lamina with lysis of the myoepithelial cells. Most naked nuclei probably result from lysed myoepithelial cells.

Adenofibroma↗

Monoclonal antibody B72.3 in benign breast lesions.

It has been suggested that the monoclonal antibody B72.3 may be useful as a diagnostic tool in fine needle aspirates of breast masses because it recognises "tumour associated glycoprotein (TAG)-72". The antigen was sought in paraffin wax sections of 43 normal and benign breast biopsy specimens, using the avidin-biotin complex technique, to assess the extent of its presence in non-malignant tissue. Strong focal staining was seen in 21 (49%) cases. In 29 cases of fibrocystic change staining was present in 17 (59%). All areas of apocrine metaplasia were positive, as well as a few normal ducts and acini and occasional areas of adenosis. Focal positivity was present in five out of 12 foci of ductal epithelial hyperplasia and in three out of seven radial scars. Staining was absent in two areas of lobular hyperplasia, three areas of sclerosing adenosis, and in a focus of lactational change. Focal positivity was also seen in two out of five fibroadenomas and in two out of three intraduct papillomas. Five normal subareolar sections and a section of normal lactating breast were negative. It is concluded that B72.3 monoclonal antibody can show focal reactivity with a variety of normal and benign epithelial mammary structures, and it is doubtful that its use would be of any help in differentiating benign from malignant cells in fine needle aspirates.

Adenofibroma↗

Combined high grade sarcoma and serous ovarian neoplasm.

A case of an ovarian serous epithelial neoplasm of borderline type admixed with sarcomatous elements is reported. This combination seems to be extremely rare with only four cases previously reported. It may represent a type of collision tumour or the development of a sarcoma in a growth with borderline differentiation.

Adenofibroma↗

Expression of gelatinase A and TIMP-2 mRNAs in desmoplastic fibroblasts in both mammary carcinomas and basal cell carcinomas of the skin.

AIMS: To compare the localisation of mRNAs for the basement membrane degrading enzyme gelatinase A (72 kilodalton type IV collagenase) and its inhibitor TIMP-2 in carcinomas of the breast and basal cell carcinomas of the skin which have little or no ability to metastasize. METHODS: In situ hybridisation was performed on formalin fixed, paraffin wax embedded blocks using 35S-labelled riboprobes on 16 mammary carcinomas, three fibroadenomas, and a benign phyllodes tumour, and on 15 basal cell carcinomas of the skin (BCC). RESULTS: Labelling for both mRNAs was detectable in 14 of 16 mammary carcinomas and in 13 of 15 BCC, most often over organising desmoplastic fibroblasts in the stroma around invasive epithelial aggregates. Some sparse labelling was seen over malignant epithelial cells in six of the mammary carcinomas but not in the BCC. Some expression of gelatinase A mRNA was also seen in fibroblasts of breast lobules adjacent to the mammary carcinomas and around engulfed adnexal elements in the BCC, but not in unaffected breast tissues, fibroadenomas, the phyllodes tumour or unaffected skin. CONCLUSIONS: Maximal expression of gelatinase A and TIMP-2 mRNAs occurs in malignant neoplasms as part of the host response to the presence of established neoplastic cells rather than as an initial response to invasion. The degree to which this is present suggests this may be a highly relevant mechanism modulating tumour differentiation, growth and progression, possibly entailing uptake via specific receptors on the tumour cell surface.

Actins↗

Vimentin expression in benign and malignant breast epithelium.

AIMS: To determine vimentin expression in epithelial cells in benign breast disease and malignant breast tumours; to assess the value of vimentin expression as a prognostic indicator in breast carcinoma. METHODS: Frozen and formalin fixed, paraffin wax embedded sections from 78 carcinomas, three phyllodes tumours, 19 fibroadenomas and 19 cases of fibrocystic disease were examined with a monoclonal antibody from the V9 clone. A correlation between vimentin expression and known prognostic indicators was sought in ductal carcinomas. The intracellular localisation of vimentin was examined in benign and malignant lesions. RESULTS: Vimentin expression was identified on frozen section in the cells of ductal (53%), lobular (86%), and mucinous (33%) carcinomas and in the luminal epithelium of fibroadenomas (68%), cases of fibrocystic disease (47%), and a malignant phyllodes tumour. Formalin fixation reduced the percentage of carcinomas and cases of benign disease in which vimentin was detected. This reduction was more pronounced in fibroadenoma and fibrocystic disease than in ductal carcinoma. Associations were identified between vimentin expression as detected on frozen section and tumour grade, size, number of lymph nodes affected, oestrogen receptor content and growth fraction. Only the association with grade was significant (p = 0.045). There was no significant correlation between any of these prognostic variables and vimentin expression on paraffin wax sections. There was no difference in the intracellular localisation of vimentin staining between benign and malignant lesions, or between low and high grade ductal carcinomas. CONCLUSION: There is some loss of vimentin immunoreactivity after formalin fixation. Vimentin expression does not assist in differentiating between benign and malignant breast disease, but is correlated with tumour grade in ductal carcinoma.

Adenofibroma↗

Cigarette smoking and benign breast disease.

The association between cigarette smoking and the occurrence of benign breast disease was assessed in a hospital-based case-control study conducted in Connecticut during 1979-81. Current smokers, but not former smokers, were at reduced risk for all benign breast diseases. The odds ratios associated with current smoking were 0.7 (95% confidence intervals = 0.6, 0.9) for fibrocystic breast disease, 0.6 (95% confidence intervals = 0.5, 0.9) for fibroadenoma, 0.6 (95% confidence intervals = 0.4, 1.0) for fibrocystic breast disease concomitant with fibroadenoma, and 0.6 (95% confidence intervals = 0.5, 0.9) for other benign breast disease. Adjustments for potentially confounding variables, including indices of medical care utilisation, affected these odds ratios only slightly. There was no convincing evidence of an association, either negative or positive, between current cigarette smoking and the degree of epithelial atypia of the fibrocystic lesions. However, the negative association between fibrocystic disease and current cigarette smoking was strongest for atypical lobular hyperplasia, which in turn has been associated with a particularly elevated risk of subsequent breast cancer.

Adenofibroma↗

Breast disease in young West Indian women: an analysis of 1051 consecutive cases.

Our analysis of 1051 breast biopsies in West Indian women under the age of 30 y revealed that 99% of the breast lumps were benign. Fibroadenoma was the commonest (67%) lesion and there was a steady increase in the frequency of fibrocystic disease with age. Carcinoma in this group is therefore rare. Thus most patients can be reassured with certainty of their benign disease and have biopsy at a convenient time.

Adenofibroma↗