Histopathology of stromal changes in tumor and tumor like lesions of breast using special stains

Purushotham Reddy, Sindhuja M.,

Abstract


Background: The interplay between a tumor and its environment is exemplified by the morphological changes observed in the stroma of human breast cancer. Stromal changes in benign, premalignant and malignant lesions of breast helps in better understanding of disease process at the level of the tumor and host stromal reaction. Objectives- (1) To compare the stromal changes in benign, proliferative breast lesions and malignant breast lesion (2) To compare the stromal changes with grade of malignant breast lesions. Methodology: This was a one-year prospective study carried out in the department of Pathology KIMS, Hubballi, Karnataka, from January 2017 to December 2017. Excision biopsies and mastectomy specimens were collected in 10% buffered formalin and subjected to paraffin processing and embedding. Five-micron thick sections were cut and stained with H&E and special histochemical stains namely Masson’s Trichrome Stain (MTS) and Verhoeff’s Van Gieson (VVG) were used to study collagen and elastin content respectively. Results: The study included 121 cases of excision biopsies and mastectomies. Benign tumors and tumor like lesions showed more collagenosis compared to malignant lesions, whereas malignant lesions showed more elastosis compared to benign lesions. Grade III malignant tumors showed more elastosis when compared to Grade II and Grade I tumors. Conclusion: Tumor stroma in breast has been neglected in many studies. Upcoming prevention, diagnostic and therapy strategies and studies should be carried in an unbiased way, allowing analysis of stromal component in addition to classical investigations of the epithelial cancer component.


Full Text:

PDF

References


Wiseman BS, Werb Z. Stromal effects on mammary gland development and breast cancer. Sci. 2002;296 (5570):1046-1049. doi:10.1126/science.1067431

Chomette G, Auriol M, Tranbaloc P, Blondon J. Stromal changes in early invasive breast carcinoma. An immunohistochemical, histoenzymological and ultra-structural study. Pathol Res Pract. 1990;186(1):70-79. doi: https://doi.org/10.1016/S0344-0338 (11) 81 012-5

Bissell MJ, Radisky D. Putting tumours in context. Nat Rev Cancer. 2001;1(1): 46-54. doi:10.1038/ 350 94059

West RB, van de Rijn M. Experimental approaches to the study of cancer–stroma interactions: recent findings suggest a pivotal role for stroma in carcinogenesis. Laboratory Investigatio2007;87(10):967. doi: 10.1038/ labinvest.3700666.

Li L, Dragulev B, Zigrino P, Mauch C, Fox JW. The invasive potential of human melanoma cell lines correlates with their ability to alter fibroblast gene expression in vitro and the stromal microenvironment in vivo. Int J Cancer. 2009; 125(8):1796-1804. doi: 10. 1002/ijc.24463.

Radhakrishnan VV, Aikat BK. Elastosis in breast carcinoma. Indian J Cancer. 1977;14(4):307-312.

Bonser GM, Dossett JA, Jull JW. Human and experimental breast cancer. Thomas; 1961.

Martinez‐Hernandez A, Francis DJ, Silverberg SG. Elastosis and other stromal reactions in benign and malignant breast tissue. An ultrastructural study. Cancer. 1977; 40 (2): 700-706. doi: 10.1002/1097-0142 (197708)40:2<700::aid-cncr2820400217>3.0.co;2-w.

Mills SE, Greenson J, Hornick J, Longacre T, editors. Sternberg's Diagnostic Surgical Pathology. 6th ed. Philadelphia: Wolters Kluwer; 2015. Chapter 30, Breast; p.317-384.

Pai MR, Pai KN, Rao RV, Naik R, Shankar-narayana, Baliga P. Connective tissue stromal changes in tumours and tumour-like lesions of the breast. Indian J Pathol Microbiol. 1999;42(3):327-332.

Azzopardi JG, Laurini RN.Elastosis in breast cancer. Cancer. 1974; 33(1):174-183. doi:10.1002/1097-0142 (197401)33:1<174::aid-cncr2820330126>3.0.co;2-x

Gaur BS, Singh R, Mishra M. Elastosis in premalignant and malignant lesions of breast- A histopathological and histochemical study. Int J Med Res Rev. 2016;4(4):668-671.doi: 10.17511/ijmrr. 2016. i04.33.

Barcellos-Hoff MH, Ravani SA. Irradiated mammary gland stroma promotes the expression of tumorigenic potential by unirradiated epithelial cells. Cancer Res. 2000;60(5):1254-1260.

Skobe M, Fusenig NE. Tumorigenic conversion of immortal human keratinocytes through stromal cell activation. Proceed Nat Acad Sci. 1998; 95(3):1050-1055. doi:10.1073/pnas.95.3.1050.

Forsberg K, Valyi-Nagy I, Heldin CH, Herlyn M, Westermark B. Platelet-derived growth factor (PDGF) in oncogenesis: development of a vascular connective tissue stroma in xenotransplanted human melanoma producing PDGF-BB. Proc Natl Acad Sci U S A. 1993; 90 (2): 393-397. doi: 10.1073/pnas. 90.2. 393

Bellini A, Mattoli S. The role of the fibrocyte, a bone marrow-derived mesenchymal progenitor, in reactive and reparative fibroses. Lab Invest. 2007; 87 (9) : 858-870. Epub 2007 Jul 2. doi:10.1038/labinvest. 3700654

Barth PJ, Ebrahimsade S, Ramaswamy A, Moll R. CD34+ fibrocytes in invasive ductal carcinoma, ductal carcinoma in situ, and benign breast lesions. Virchows Archiv. 2002; 440(3): 298-303. doi:10.1007/s004280 100530.

Mori L, Bellini A, Stacey MA, Schmidt M, Mattoli S. Fibrocytes contribute to the myofibroblast population in wounded skin and originate from the bone marrow. Exp Cell Res. 2005;304(1):81-90. Epub 2004 Dec 8. doi:10.1016/j.yexcr.2004.11.011

Shivas AA, Douglas JG. The prognostic significance of elastosis in breast carcinoma. J R Coll Surg Edinb. 1972;17(5):315-320.

Fisher ER, Gregorio RM, Fisher B, Redmond C, Vellios F, Sommers SC. The pathology of invasive breast cancer. A syllabus derived from findings of the National Surgical Adjuvant Breast Project (protocol no. 4). Cancer. 1975;36(1):1-85. doi:10.1002/1097-0142 (197507) 36:1<1::aid-cncr2820360102>3.0.co;2-4

Anastassiades OT, Bouropoulou V, Kontogeorgos G, Tsakraklides EV. Duct elastosis in infiltrating carcinoma of the breast. Pathol Res Pract. 1979; 165 (4): 411-421. doi: https://doi.org/10.1016/S0344-0338 (79) 80033-3

Parfrey NA, Doyle CT. Elastosis in benign and malignant breast disease. Hum Pathol. 1985;16(7):674-676. doi:10.1016/s0046-8177(85)80150-7

Jackson JG, Orr JW. The ducts of carcinomatous breasts, with particular reference to connectivetissue changes. J Pathol Bacteriol. 1957;74(2):265-273. doi: https://doi.org/10.1002/path.1700740203

Lundmark C. Breast cancer and elastosis. Cancer. 1972;30(5):1195-1201. doi:10.1002/1097-0142 (197211) 30:5<1195::aid-cncr2820300509>3.0.co;2-h

Douglas JG,Shivas AA. The origins of elastica in breast carcinoma.J R Coll SurgEdinb.1974;19(2):89-93.

Wallgren A, Silfverswärd C, Eklund G. Prognostic factors in mammary carcinoma. Acta Radiol Ther Phys Biol. 1976;15(1):1-16.

Mitchell RE, Mitchell RM, Shugg D, Wyld C. The prognosis of breast cancer based on histological assessment. Aust NZJ Surg. 1979;49(3):305-312. doi: https://doi.org/10.1111/j.1445-2197.1979.tb07670.x

Robertson AJ, Brown RA, Cree IA, MacGillivray JB, Slidders W, Beck JS. Prognostic value of measurement of elastosis in breast carcinoma. J Clinic Pathol 1981;34:738-743.doi:10.1136/jcp.34.7.738

Aiyer HM, Jain M, Thomas S, Logani KB. Diagnostic stromal histomorphology in fibroepithelial breast lesions: a fresh perspective. Indian J Pathol Microbiol. 2000;43(1):5-12.

Wernicke M, Piñeiro LC, Caramutti D, Dorn VG, Raffo MM, Guixa HG, et al. Breast cancer stromal myxoid changes are associated with tumor invasion and metastasis: a central role for hyaluronan. Mod Pathol. 2003; 16(2): 99-107. doi:10.1097/01.MP.0000051582. 75890.2D


Refbacks

  • There are currently no refbacks.