Dermatopathology of the Female Breast

Abstract

To better define the spectrum of neoplastic and inflammatory diseases that affect female breast skin and the nipple-areola complex, we searched an institutional dermatopathology database and identified 500 specimens of female "breast" (from consecutive records accessioned January 2009-March 2011), 143 specimens of "areola," 124 specimens of "nipple" (records from the latter 2 groups were from patients evaluated June 1992-March 2011), and 500 control specimens of "abdomen" (accessioned January 2010-March 2011). Most specimens obtained from breast skin (76%) represented melanocytic or epithelial proliferations (eg, nevi, seborrheic keratoses, and cysts), as did those from the abdomen, whereas many from the nipple (41%) and areola (60%) were of inflammatory dermatoses. A striking finding was eosinophilic spongiosis (ES) in most areola specimens with spongiotic dermatitis (78%); in contrast, ES was identified in 50% and 31% of spongiotic dermatitis specimens from nipple and breast skin, respectively. ES was associated with a clinical diagnosis of dermatitis in all patients except one (who had pemphigus). Metastatic breast cancer was identified in 28 of 767 specimens (4%), including 6 of 124 (5%) from the nipple. Five of 124 specimens from the nipple (4%) and 1 of 143 from the areola (1%) showed Paget disease. All but one patient with Paget disease showed acantholytic features and none had tissue eosinophils. Abnormalities categorized as complications of radiotherapy, including mild fibrosis and vascular ectasias, morphea, and angiosarcoma, constituted a minority of cases. Our data and the literature indicate that few disorders specifically affect breast skin, but the nipple-areola complex should be approached with a different set of diagnostic considerations.

Reflectance Confocal Microscopy for Diagnosis of Mammary Paget’s Disease

“…The dark halo found in target structures probably relates to clefts between PCs and the surrounding epidermis due to mucin secretion by the former. These findings are in agreement with the described glandular features of MPD in immunohistochemistry (7). Dark holes correspond to large cells with abundant and pale cytoplasm, while bright central areas in target structures relate to pleomorphic nuclei.…”

“…Pigmented mammary Paget's disease (PMPD) corresponds to an even less common variant, frequently simulating other pigmented lesions of the nipple, including melanoma (3)(4)(5). According to the epidermotropic theory, Paget cells (PCs) originate from cancer cells that migrate via the lactiferous ducts along the basal membrane, to invade the epidermis of the nipple and areola (6,7). Considering its intra-epidermal spreading, PCs are therefore potentially demonstrable using non-invasive diagnostic techniques with near-cellular resolution, such as reflectance confocal microscopy (RCM) (8).…”

Oxalate induces breast cancer

“…Always a ratio of 1:5 was maintained between the milligrams of tissue and micro-liters of buffer used, approximately 200 mg of breast tissue (tumor or not) was homogenized in 500 μL of buffer. This process was made on ice (4 °C) and then centrifuged for 15 min at 15,000 x g using a cooling centrifuge (4 °C) to separate the microsomal [ 26 ] and supernatant (SF) fractions. SF was stored at −20 °C to future protein analysis by SDS page and Western Blot.…”

“…Obtaining of total homogenate (TH) from attaches cell: Cell growth medium was removed from 35 mm well and then cells were rinsed with PBS. After that, cells were lysed with 90 μL of RIPA buffer (NaCl 150 mM, Tris–HCl 50 mM, EDTA 0,5 mM, Tritón 1 % y SDS 0,1 %) plus complete protease inhibitor cocktail [ 7 ] using a scrapper and then centrifuged for 15 min at 15,000 x g using a cooling centrifuge (4 °C) to separate the microsomal [ 26 ] and supernatant (SF) fractions. SF was stored at −20 °C to future protein analysis by SDS page and Western Blot.…”

Rare Areolar Basal Cell Carcinoma Above Invasive Breast Carcinoma: Coincidence or Induction?

“…5 In addition to environmental risk factors, genetic, immunological, physiological, and pathophysiological factors can contribute to this association. 1–3,5 An example of a risk factor associated with this reported case is radiotherapy exposure. 6–8 Some studies established a cause–effect relation between breast radiotherapy exposure and neoplasms such as breast angiosarcoma and other breast sarcomas due to the DNA damage caused by ionized radiation in soft tissues.…”