Phenotypic Alterations in Ductal Carcinoma In Situ-associated Myoepithelial Cells

Hilson, Justin B.; Schnitt, Stuart J.; Collins, Laura C.

doi:10.1097/pas.0b013e318180431d

Cited by 82 publications

(75 citation statements)

References 21 publications

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“…30,31 Furthermore, there is also recent evidence that even the myoepithelial cells that are present around DCIS showed phenotypic alternations when compared with those lining normal ductal lobular units, and this may also have a role in the invasiveness of DCIS. 32 The current series also showed the absence of cancerization of the lobules by the DCIS in the biopsy to be another predictor for invasion. Lobular extension has been shown to be a significant predictor for invasion, 21 and when the size is 40.4 cm.…”

supporting

confidence: 55%

Predictors of invasion in needle core biopsies of the breast with ductal carcinoma in situ

Chan

Vong

et al. 2010

Modern Pathology

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A significant proportion of ductal carcinomas in situ (DCISs) of the breast diagnosed on core biopsies had invasion upon excision. An assessment of various invasion predictors in the biopsies yielded conflicting results. A cohort of 157 cases with needle core biopsy diagnosed with DCISs (including 109 histologically proven DCISs, and 48 cases with invasion upon excision) were evaluated for the numbers of positive and total cores, the percentage of positivity, lobular cancerization, tumor nuclear grade, necrosis, calcification, predominate histological pattern, lymphocytic infiltrate and excisional tumor size. The mean positive core percentage and excisional tumor size were 76% and 2.8 cm for invasive and 66% and 1.9 cm for noninvasive groups. In the biopsy of the invasive group, cancerization of lobules was present in 52%, and nuclear grades 1, 2 and 3 were present in 31, 31 and 38%, respectively. Large comedo and small noncomedo necroses were present in 48 and 10%, whereas large and small calcifications were present in 16 and 21%. Solid, cribriform and papillary patterns were observed in 88, 38 and 21%, respectively. Moderate to marked lymphoid infiltrate was present in 31%. In the biopsy of the noninvasive group, cancerization of lobules was present in 69%, and the nuclear grades 1, 2 and 3 were present in 23, 48 and 29%, respectively. Large comedo and small noncomedo necroses were present in 35 and 11%, whereas large and small calcifications were present in 33 and 23%. Solid, cribriform and papillary patterns were observed in 85, 39 and 9%, respectively. Moderate to marked lymphoid infiltrate was present in 36%. Comparing these groups, a higher positive core percentage, papillary pattern and less cancerization of lobules in the cores and larger excisional tumor size were associated with a higher chance of invasion. Calcification, necrosis and nuclear grade were not significant invasion predictors.

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supporting

confidence: 55%

Predictors of invasion in needle core biopsies of the breast with ductal carcinoma in situ

Chan

Vong

et al. 2010

Modern Pathology

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“…Recently, absence of a myoepithelial cell layer has also been observed in some metaplastic apocrine glands [2,3]. Various studies have shown phenotypic alterations in ME cells associated with benign and in-situ lesions as compared to normal breast [4][5][6][7][8]. The interactive relationship between myoepithelial and luminal cells appears to be complex, with the integrity of the basement membrane being of prime importance in preventing malignant transformation [1,[6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, whether or not absence of myoepithelial cells in neoplastic lesions of the breast necessarily equates with stromal invasion has been controversial. This applies especially to encapsulated papillary carcinoma [2][3][4][5]. The role of ME cells in tumorigenesis has been the focus of much research in recent years [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Hypersecretory Thyroid-like Adenosis of the Breast: A Distinct Benign Entity Devoid of Myoepithelial Cells

Munday¹

2015

J Clin Exp Pathol

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Most infiltrative epithelial proliferations of the breast lacking a myoepithelial cell layer are malignant. The notable exception is Microglandular Adenosis (MGA). Lack of myoepithelial cells has also been noted occasionally in metaplastic apocrine glands. Here, we present a previously undescribed breast lesion that we have termed "Hypersecretory Thyroid-Like Adenosis" (HTLA). HTLA consists of multiple dilated glands of varying sizes preserving a lobulated architecture. The glands are lined by a single layer of bland cuboidal or columnar cells. Some nuclei have cleared chromatin, some exhibit grooves and others contain pseudo-inclusions reminiscent of papillary carcinoma of thyroid. Dense eosinophilic secretions, positive for PAS-Diastase and resembling thyroidal colloid, are present in many of the lumens. A thick basement membrane is present around each gland. There are no Myoepithelial (ME) cells present on H&E examination, immunohistochemistry or ultrastructural study. The immunohistochemical stain for S-100 protein shows weak focal nuclear and cytoplasmic staining of the minority of the luminal cells (<20% of cells). The lesion is ER negative. HTLA has some features similar to, but is overall distinctly different from MGA. In particular, the preserved lobular architecture, macroacinar structures, distinctive nuclear features, and lack of diffusely strong immunostaining for S-100 protein are features unlike MGA. This lesion was an incidental finding in a partial mastectomy performed for invasive ductal carcinoma but showed no spatial relationship, morphological or immunohistochemical similarities to the breast carcinoma.

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“…Altered expression of these markers has been observed in the myoepithelial cells of DCIS lesions. Hilson et al were the first to report reduced staining intensity of DCIS-associated myoepithelial cells with various myoepithelial cell markers, lending support to the idea that these myoepithelial cells are phenotypically abnormal [42]. These authors also found that SMMHC, CD10 and CK 5/6 have lower sensitivity for DCISassociated myoepithelial cells than do SMA, p63 and calponin [42].…”

Section: The Transition From Dcis To Invasive Carcinomamentioning

confidence: 92%

“…Hilson et al were the first to report reduced staining intensity of DCIS-associated myoepithelial cells with various myoepithelial cell markers, lending support to the idea that these myoepithelial cells are phenotypically abnormal [42]. These authors also found that SMMHC, CD10 and CK 5/6 have lower sensitivity for DCISassociated myoepithelial cells than do SMA, p63 and calponin [42]. At our institution, we used two of the most common markers, p63 and calponin, in a large series of DCIS cases which revealed heterogeneous expression of these myoepithelial markers [ Figure 2].…”

Section: The Transition From Dcis To Invasive Carcinomamentioning

confidence: 93%

Ductal carcinoma in situ of the breast: the importance of morphologic and molecular interactions

2016

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Phenotypic Alterations in Ductal Carcinoma In Situ-associated Myoepithelial Cells

Cited by 82 publications

References 21 publications

Predictors of invasion in needle core biopsies of the breast with ductal carcinoma in situ

Predictors of invasion in needle core biopsies of the breast with ductal carcinoma in situ

Hypersecretory Thyroid-like Adenosis of the Breast: A Distinct Benign Entity Devoid of Myoepithelial Cells

Ductal carcinoma in situ of the breast: the importance of morphologic and molecular interactions

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