Fas及Fas-L在乳腺浸润性导管癌及癌旁组织中的表达

目的 探讨Ｆａｓ及Ｆａｓ－Ｌ与乳腺浸润性导管癌发生、发展及肿瘤分化程度的关系。方法 用免疫组织化学方法对５０例乳腺浸润性导管癌及其癌旁组织的Ｆａｓ－Ｌ进行检测。结果 Ｆａｓ有乳腺浸润性导管癌中的表达阳性率为７６％,显著低于其癌旁组织的９６％（Ｐ〈０．０１）;Ｆａｓ－Ｌ在乳腺浸润性导管癌中的表达阳性率９４％,显著高于其癌旁组织的８４％（Ｐ〈０．０１）,不同分化程度乳腺浸润性导管癌中的表达阳性率为９４     

A study on the vascular proliferation in tissues around the tumor in breast cancer

In order to study the vascular proliferation in human breast cancer, blood vessels were counted, per square millimeter, in the tissue immediately around tumors. Mastectomized specimens of 84 patients with breast cancer and specimens from 10 patients with benign mammary diseases were stained by hematoxylin eosin and, where required, by the avidin biotin peroxidase complex method for laminin staining. The vascular density around the breast cancer tissue was 20.35 +/- 8.40/mm2, which was significantly higher than the value of 13.44 +/- 5.85/mm2 for noncancerous mammary tissues (p less than 0.001) or the value of 12.65 +/- 4.12/mm2 for benign mammary disease tissues (p less than 0.01). Among the breast cancers, noninvasive carcinoma had a higher vascular density (28.44 +/- 6.15/mm2) than invasive carcinoma (19.73 +/- 8.22/mm2, p less than 0.02). According to the Japan Mammary Cancer Society Classification of invasive ductal carcinoma, vascularity was higher in the papillotubular type of cancer than in the solid-tubular or scirrhous types of cancer (p less than 0.02), although the papillotubular type had the lowest rate of nodal metastasis and vascular invasion as compared with the scirrhous and solid-tubular types. The vascular density around the tumors did not change in association with an increase in tumor size and it was suggested that blood vessels around a tumor would increase almost in proportion to the square of the tumor diameter.     

Expression of cyclooxygenase-2 in breast carcinogenesis and its relation to HER-2/neu and p53 protein expression in invasive ductal carcinoma

The purpose of this study was to evaluate cyclooxygenase-2 (COX-2) expression in the successive steps of breast carcinogenesis and to determine its correlation with HER-2/neu and p53 expression in invasive ductal carcinomas of the breast. Immunohistochemical staining with anti-COX-2 antibody was performed in normal breast tissue, usual hyperplasia, ductal carcinoma in situ, and invasive ductal carcinoma. Expression of COX-2 in invasive ductal carcinoma was correlated with immunohistochemical expression of HER-2/neu and p53 protein. COX-2 expression was found to be progressively elevated along the continuum from normal breast tissue to invasive ductal carcinoma (P<0.001). COX-2 expression significantly correlated with p53 and HER-2/neu protein expression (P<0.05 and P<0.001). On multivariate analysis, only TNM stage and elevated COX-2 expression correlated with survival. Our results suggest that COX-2 may be involved in the carcinogenesis of the breast and may be an independent prognostic indicator in patients with invasive ductal carcinoma. HER-2/neu and p53 are likely to be involved in the regulation of COX-2 expression in invasive ductal carcinomas of the breast.     

Ten-year follow-up of breast carcinoma in situ in Connecticut.

Statistics from the Connecticut Tumor Registry from 1979 to 1988 were examined, and individual medical records from 1979 to 1983 were also reviewed. Three hundred nineteen medical records were available for review, documenting 220 cases of ductal carcinoma in situ and 102 cases of lobular carcinoma in situ. In 1979, there were 33 new cases of ductal carcinoma in situ reported to the Connecticut Tumor Registry, representing 1.8% of all breast cancers. There has been a yearly increase in ductal carcinoma in situ, with 200 new cases, or 7.4% of all breast cancers, reported in 1988. Forty-eight (22%) of 217 patients with ductal carcinoma in situ had bilateral breast involvement with ductal carcinoma in situ or an invasive breast cancer. Ten (83%) of 12 mastectomy specimens from patients with ductal carcinoma in situ who presented with nipple discharge demonstrated residual tumor, suggesting a more diffuse involvement. Two of the three reported recurrences involved nipple discharge. Thirty-seven (16.8%) of the 220 patients with ductal carcinoma in situ and six (5.9%) of the 102 patients with lobular carcinoma in situ were diagnosed as having another unrelated cancer. Ongoing clinical trials will direct optimum therapy for patients increasingly diagnosed as having ductal carcinoma in situ.     

CD24在乳腺癌组织中表达的意义及其与Ki67、Bcl-2的关系

目的 研究乳腺浸润性导管癌组织中CD24的表达及与细胞核增殖抗Ki67及凋亡抑制蛋白Bcl-2的关系,探讨CD24在乳腺癌发生发展中的作用.方法 应用免疫组化ElivisiDnTM Plus二步法检测86例乳腺浸润性导管癌组织和30例非瘤乳腺上皮组织中CD24及Ki67、Bcl-2的表达情况,分析CD24表达与Ki67、Bcl-2以及患者年龄、肿瘤大小、组织病理学分级、淋巴结转移、临床分期等临床病理学参数之间的关系.结果 在86例乳腺浸润性导管癌中CD24表达的阳性率为87.2%(75/86),与对照组比较均有统计学差异(P<0.01);CD24表达与患者年龄、肿瘤大小、组织病理学分级、临床分期未见显著相关(P0.05),与腋窝淋巴结转移呈正相关(P<0.01);乳腺癌CD24表达与Ki67表达呈正相关(P<0.01),与Bel-2表达没有相关性(P0.05).结论 CIY24蛋白的表达与乳腺癌细胞增殖及侵袭转移具有相关性,是判断肿瘤生物学行为和患者预后的重要参考指标之一.     

瘦素及瘦素受体在乳腺癌中的表达及临床意义

目的 探讨瘦素及其受体mRNA及蛋白的表达在乳腺癌发生、发展中的意义。方法 采用巢式逆转录-聚合酶链反应〈RT-PCR）和免疫组织化学方法检测39例乳腺癌及其周围正常乳腺组织瘦素及其受体的mRNA及蛋白表达，分析乳腺癌组织瘦素与瘦素受体表达的相关性及其与临床病理之间的关系。结果 瘦素mRNA及蛋白在正常乳腺及乳腺癌组织阳性表达率均为100．00％；瘦素受体mRNA和蛋白在乳腺癌组织阳性表达率为74．40％。正常乳腺组织mRNA阳性表达率7．69％；瘦素及其受体在乳腺癌组织的表达量高于正常组织。差异具有统计学意义（P〈0．01）；瘦素受体的表达与瘦素表达明显相关（P〈0．01）。瘦素及瘦素受体高表达与乳腺癌的转移及浸润明显相关（P〈0．01）。结论 瘦素在乳腺癌的发生发展中可能起着促进作用，瘦素及其受体表达情况可以作为乳腺癌诊断或预后的指标。     

A study on the vascular proliferation in tissues around the tumor in breast cancer

In order to study the vascular proliferation in human breast cancer, blood vessels were counted, per square millimeter, in the tissue immediately around tumors. Mastectomized specimens of 84 patients with breast cancer and specimens from 10 patients with benign mammary diseases were stained by hematoxylin eosin and, where required, by the avidin biotin peroxidase complex method for laminin staining. The vascular density around the breast cancer tissue was 20.35±8.40/mm², which was significantly higher than the value of 13.44±5.85/mm² for noncancerous mammary tissues (p<0.001) or the value of 12.65±4.12/mm² for benign mammary disease tissues (p<0.01). Among the breast cancers, noninvasive carcinoma had a higher vascular density (28.44±6.15/mm²) than invasive carcinoma (19.73±8.22/mm², p<0.02). According to the Japan Mammary Cancer Society Classification of invasive ductal carcinoma, vascularity was higher in the papillotubular type of cancer than in the solid-tubular or scirrhous types of cancer (p<0.02), although the papillotubular type had the lowest rate of nodal metastasis and vascular invasion as compared with the scirrhous and solid-tubular types. The vascular density around the tumors did not change in association with an increase in tumor size and it was suggested that blood vessels around a tumor would increase almost in proportion to the square of the tumor diameter.     

Location and extent of positive resection margins and ductal carcinoma in situ in lumpectomy specimens of ductal breast carcinoma examined with a microscopic three-dimensional view

The location of positive margins in lumpectomy specimens for ductal carcinoma could be predicted due to the common pattern of the geographic relationship between the intraductal and invasive carcinomas. To test this hypothesis, 62 lumpectomy specimens for ductal carcinoma of the breast were submitted for this study. The specimens were microscopically examined by serially sectioning them into giant sections in a plane parallel to the chest wall (frontal plane). The margins were identified as proximal (closest to the nipple), distal (opposite to proximal), and peripheral (nonproximal or distal). We found that the location of positive or close margins was proximal in 6 cases, peripheral in 13 cases, and none were found to be distal. Ductal carcinoma in situ (DCIS) was found to be located in the area adjacent to the invasive carcinoma. The invasive carcinoma was located at the periphery of the intraductal carcinoma. All six specimens with invasive carcinoma without DCIS had free margins. Nine of 16 specimens (56%) with extensive intraductal carcinoma (EIC) component and 7 of 40 (18%) with DCIS but negative EIC contained positive or close margins involved by DCIS. One case with multifocal invasive carcinoma measuring 3.5 cm in diameter and with DCIS but EIC negative had margins involved by both DCIS and invasive carcinoma. In conclusion, in ductal carcinoma, invasive carcinoma arose at the peripheral areas of the DCIS. DCIS tends to spread toward the nipple and the peripheral margins of the resected specimens. Incomplete excision of the ductal carcinoma and the wide positive margins are most likely caused by the failure to estimate the extent and location of DCIS.     

BCSG1,S100A4,VEGF在乳腺肿瘤中的表达

目的 探讨BCSG1、S100A4和VEGF在人乳腺肿瘤中的表达情况,研究其在乳腺癌发生、发展中的生物学意义并观察其与乳腺癌浸润及转移的内在关系.方法 本研究通过对40例乳腺纤维腺瘤、62例乳腺浸润性导管癌组织(根据有无腋窝淋巴结转移分为1、2两组)及其癌旁组织48例,采用免疫组织化学技术SP法,对上述三指标的表达情况进行对比观察.结果 BCSG1、S100A4和VEGF在乳腺组织中的阳性表达四组比较差异均有统计学意义(P＜0.05).结论 乳腺癌组织中BCSG1、S100A4和VEGF阳性表达率升高,提示乳腺肿瘤的浸润和转移能力增强;三指标的阳性表达率和肿瘤病理分级呈正相关;联合检测三种指标的表达状况将有助于乳腺癌的早期诊断和预后判断.     

Bmi-1 及Mel-18在乳腺癌中的表达及其与临床病理特征的关系

目的：探讨Bmi-1和Mel-18在乳腺癌组织中的表达和临床意义。方法：采用RT-PCR和免疫组织化学染色法检测Bmi-1和Mel-18基因与蛋白在40例乳腺癌组织和20例乳腺良性肿瘤组织及20例正常乳腺组织中的表达。分析两者在乳腺癌组织中的表达情况和相关性,以及两者表达与临床病理因素的关系。结果：Bmi-1 mRNA的表达和蛋白阳性率在正常乳腺组织、乳腺良性组织、乳腺癌组织均呈明显依次递增（均P<0.05）,而Mel-18则基本呈反向趋势（正常乳腺组织与乳腺良性组织间差异不明显）;乳腺癌组织中Bmi-1与Mel-18 mRNA及蛋白表达之间均明显呈负相关（r=-0.317,P=0.023;r=-0.413,P=0.008）;两者基因表达和蛋白阳性率水平与淋巴结转移及临床分期密切相关（均P<0.05）,而与患者的年龄、绝经状况、肿瘤大小、组织学分级无关（均P>0.05）。结论：Bmi-1过表达与Mel-18低表达可能是乳腺组织恶性转变以及乳腺癌发生浸润转移的重要生物学标志。

     

Heterogenic Loss of the Wild-Type BRCA Allele in Human Breast Tumorigenesis

Background For individuals genetically predisposed to breast and ovarian cancer through inheritance of a mutant BRCA allele, somatic loss of heterozygosity affecting the wild-type allele is considered obligatory for cancer initiation and/or progression. However, several lines of evidence suggest that phenotypic effects may result from BRCA haploinsufficiency. Methods Archival fixed and embedded tissue specimens from women with germ line deleterious mutations in BRCA1 or BRCA2 were identified. After pathologic review, focal areas of normal breast epithelium, atypical ductal hyperplasia, ductal carcinoma-in-situ, and invasive ductal carcinoma were identified from 14 BRCA1-linked and 9 BRCA2-linked breast cancers. Ten BRCA-linked prophylactic mastectomy specimens and 12 BRCA-linked invasive ovarian carcinomas were also studied. Laser catapult microdissection was used to isolate cells from the various pathologic lesions and corresponding normal tissues. After DNA isolation, real-time polymerase chain reaction assays were used to quantitate the proportion of wild-type to mutant BRCA alleles in each tissue sample. Results Quantitative allelotyping of microdissected cells revealed a high level of heterogeneity in loss of heterozygosity within and between preinvasive lesions and invasive cancers from BRCA1 and BRCA2 heterozygotes with breast cancer. In contrast, all BRCA-associated ovarian cancers displayed complete loss of the wild-type BRCA allele. Conclusions These data suggest that loss of the wild-type BRCA allele is not required for BRCA-linked breast tumorigenesis, which would have important implications for the genetic mechanism of BRCA tumor suppression and for the clinical management of this patient population.     

乳腺癌组织中DNA修复酶MGMT、XRCC1的表达与临床预后因素的关系

目的 探讨乳腺癌组织中O6-甲基鸟嘌呤-DNA-甲基转移酶(MGMT)和X线修复交叉互补基因1(XRCC1)的表达及与临床预后因素的关系.方法 采用SP免疫组织化学法检测110例乳腺癌石蜡标本、19例纤维腺瘤石蜡标本及11例正常乳腺组织石蜡标本中MGMT和XRCC1蛋白的表达,分析其与临床预后因素的关系.结果 110例乳腺癌组织中MGMT阳性表达率为71.8%,其表达与乳腺癌患者的病理类型、浸润性导管癌的病理分化程度、淋巴结是否转移及ER表达明显相关(P＜0.05).XRCC1阳性表达率为30.9%,其表达与患者的肿瘤大小、浸润性导管癌的病理分化程度明显相关(P＜0.05).此外,MGMT与XRCC1的表达明显相关(P＜0.05),生存分析表明MGMT、XRCC1是影响生存期的因素(P＜0.05).结论 DNA修复基因MCMT及XRCC1是临床评估乳腺癌恶性程度、判断预后及制定治疗策略的病理指标之一.     

Expression of PH-20 in normal and neoplastic breast tissue

BACKGROUND: Tumor metastasis involves a sequence of interrelated steps, of which penetration beyond the basement membrane is an essential component. Hyaluronic acid (HA) is a major structural component of the complex proteoglycans found in extracellular matrices and basement membranes. Hyaluronidase (PH-20) degrades HA, resulting in the disruption of basement membrane integrity and possible tumor dissemination. MATERIALS AND METHODS: Total RNA was extracted from samples (n = 51) of normal breast tissue (n = 12), ductal carcinoma in situ (DCIS) (n = 12), infiltrating ductal breast adenocarcinoma (n = 13), and metastatic breast cancer to lymph nodes (n = 14). RT-PCR was used to determine the relative level of PH-20 in each specimen. RESULTS: PH-20 was detected in 41/51 (80.4%) of the specimens evaluated. PH-20 was present in 12/12 (100%) normal breast tissues; 8/12 (66.7%) DCIS; 13/13 (100%) invasive breast cancers; and 8/14 (57.1%) metastases. Of those specimens in which PH-20 was detected, there were increased levels of PH-20 in metastatic breast cancer to lymph nodes compared to DCIS and invasive breast cancer. Stratification of specimen by race revealed that African American women had higher levels of PH-20 with invasive and metastatic beast cancer. CONCLUSIONS: Increased levels of PH-20 are noted in invasive and metastatic breast cancer compared to DCIS. Tumors from African American women with invasive and metastatic breast cancer demonstrated higher levels of PH-20 than Caucasians. Varying levels of PH-20 in mammary tissue may contribute to early invasion and metastasis of breast cancer.     

肾透明细胞癌组织中T细胞淋巴瘤侵袭和转移诱导蛋白1表达及其临床意义

目的 探讨肾透明细胞癌组织中T细胞淋巴瘤侵袭和转移诱导蛋白l( T-lymphomainvasion and metastasis 1,Tiam1)的表达与临床病理特征及预后的关系. 方法 选取原发性肾透明细胞癌组织标本107例.男78例,女29例.年龄32～87岁,平均59岁.肿瘤大小按手术切除标本测量.肿瘤最大径1.4～7.6 cm,平均4.5 cm.≤2.5 cm者23例,2.6 ～5.0 cm者65例,＞5.0 cm者19例.有淋巴结转移者46例,有血管浸润者32例.Fuhrman分级:Ⅰ级22例,Ⅱ级41例,Ⅲ级27例,Ⅳ级17例.2002 AJCC TNM分期:T129例,T244例,T3 16例,T4 18例.20例正常肾组织标本作为对照组.免疫组织化学方法检测标本中Tiam1蛋白表达,结合临床病理学资料进行分析.随访5～8年,生存分析采用Kaplan-Meier法,组间差异采用Log-rank检验. 结果 20例正常肾组织中Tiam1蛋白阳性表达率为15.0％ (3/20),肿瘤组织中Tiam1蛋白阳性表达率为73.8％ (79/107),组间差异有统计学意义(P＜0.01);Ⅰ～Ⅱ级与Ⅲ～Ⅳ级肾癌组织中Tiam1蛋白高表达阳性率分别为47.6％( 30/63)、72.7％( 32/44),T1～T2期与T3 ～T4期肾癌组织分别为49.3％(36/73)、76.5％ (26/34),无淋巴结转移组与有淋巴结转移组分别为47.5％ (29/61)、71.7％ (33/46),无血管浸润组与有血管浸润组分别为48.0％(36/75)、81.3％(26/32),组间差异均有统计学意义(P＜0.01).Tiam1蛋白高表达组与低表达组患者术后5年生存率分别为46.8％(29/62)、84.4％( 38/45),组间差异有统计学意义(P＜0.05). 结论 肾癌组织中Tiam1蛋白阳性表达率明显高于正常组织,Tiam1蛋白高表达与肾癌的分期、分级、淋巴结转移、血管浸润有关,与患者性别、年龄、肿瘤大小无相关性.检测Tiam1蛋白有助于肾癌的诊断及预后评估.     

P504S immunohistochemical detection in 405 prostatic specimens including 376 18-gauge needle biopsies

P504S is a recently described, prostate cancer-specific gene that encodes a protein involved in the beta-oxidation of branched chain fatty acids. A recent study has shown that immunohistochemical detection of P504S gene product is a sensitive and specific marker of prostatic carcinoma in formalin-fixed, paraffin-embedded tissues. We performed a detailed analysis of P504S protein expression in a large series of prostate and bladder specimens with special emphasis on staining in specific morphologic patterns of prostatic adenocarcinoma, posthormonal and radiation therapy cases, and invasive urothelial carcinoma. A total of 366 prostate needle core biopsies from 124 patients with prostate cancer, 10 biopsies from 2 patients without prostate cancer, 28 prostatectomy specimens (16 with specific morphologic patterns, 7 posthormonal therapy and 5 postradiation therapy specimens), 5 bladder specimens with invasive urothelial carcinoma, and a single transurethral resection specimen from a patient with hormonally treated prostate cancer and invasive urothelial carcinoma were stained with P504S monoclonal antibody at a 1:250 dilution using standard heat-induced epitope retrieval and avidin-biotin technique. Extent (0, no staining; 1+, 1-10% staining; 2+, 11-50% staining; 3+, > or =51% staining) and location (luminal, subluminal, and diffuse cytoplasmic) of immunoreactivity in carcinoma and benign tissues were recorded. A total of 153 of 186 biopsies (82%) with prostatic adenocarcinoma stained for P504S. Pseudohyperplastic, atrophic, ductal, and mucinous prostatic carcinomas stained similarly, as did cases treated with hormone or radiotherapy. In 81 of 377 (21%) foci of benign prostatic tissue there was staining that was almost always focal, faint, and noncircumferential. Seminal vesicles did not stain for P504S. Five of six (83%) specimens with invasive urothelial carcinoma had 2+ staining and one case had focal staining. We conclude that immunohistochemistry for P504S has potential utility in the diagnosis of prostate cancer, including those treated by hormones and radiation. Circumferential luminal to subluminal and diffuse cytoplasmic staining is the most specific staining pattern for prostatic carcinoma and is almost never associated with benign prostatic tissue. However, a negative P504S immunostain does not automatically rule out prostate cancer, as 18% of cases were negative. Additionally, occasional benign glands, high-grade prostatic intraepithelial neoplasia, atypical adenomatous hyperplasia, and urothelial carcinoma may express P504S. Therefore, we think that P504S is best used only in conjunction with strict light microscopic correlation and preferably with high molecular weight cytokeratin immunostaining.     

Mammary endocrine ductal carcinoma in situ: a case report

Endocrine differentiation represents a pathway of neoplastic development available to a range of breast cancers. This pattern occurs in tumors with different morphological appearances as ductal carcinoma in situ (DCIS), mucinous carcinoma, a variant of lobular carcinoma, and low-grade invasive ductal carcinoma. Endocrine ductal carcinoma in situ is an uncommon entity. It occurs in older women with a mean age of 70 years. Histologically it shows expansile intraductal growth forming solid sheets and festoons transversed by delicate fibrovascular septa. Conventional microscopy permits the diagnosis in most cases. Specialized techniques such as immunohistochemistry and electron microscopy can serve as the basis of diagnosis in the absence of the appropriate morphological features. We present a 68-year-old female with a 1.5-cm firm mobile nodule of the left breast. Mammography and ultrasounds showed a 15 x 15-mm circumscribed solid lobulated nodule. The mass was excised and pathology was positive for endocrine DCIS. Although endocrine DCIS has a biologic marker profile similar to that of well-differentiated or noncomedo DCIS it may constitute a different histogenetic pathway of carcinogenesis in the breast. The tumor may exhibit the invasive characteristics of a neuroendocrine neoplasm. Larger studies and longer follow-up are needed for the determination of the clinical behavior.     

BRCA1和p120ctn在乳腺浸润性导管癌中的表达及其临床意义

目的:观察乳腺浸润性导管癌组织中BRCA1和p120ctn表达及其与临床病理特征之间的关系,探讨它们在乳腺浸润性导管癌发生、发展中的作用及临床应用价值。方法:采用免疫组化方法,检测BRCA1蛋白及p120ctn在乳腺浸润性导管癌、乳腺腺病和癌旁正常组织的表达。分析两者的表达与各病理特征的关系及其两者的相关性。结果:在60例乳腺浸润性导管中,BRCA1蛋白及p120ctn阳性率分别为60.0%(36/60)和35.0%(21/60),分别低于各自在乳腺腺病和癌旁正常组织中的表达(均P<0.05);BRCA1蛋白表达状态与患者高发病年龄、临床病理分期、伴有腋淋巴结转移以及组织学分级有关(均P<0.05),而与肿瘤大小无关(P>0.05);p120ctn表达状态与临床病理分期、伴有腋淋巴结转移以及组织学分级有关(均P<0.05),而与发病年龄、肿瘤大小无关(均P>0.05);BRCA1蛋白与p120ctn在乳腺浸润性导管癌组织中的表达呈正相关(r=0.314,P<0.05)。结论:BRCA1与p120ctn的联合检测可作为乳腺浸润性导管癌诊断、恶性程度及预后判断的指标,为临床个体化治疗提供依据。     

Declining estrogen receptor-beta expression defines malignant progression of human breast neoplasia

It has been shown that the risk of breast cancer developing in certain morphologically identifiable benign breast lesions correlates with expression of estrogen receptor alpha (ER-alpha). Although ER-alpha and ER-beta genes share a large degree of homology, it is generally thought that their distribution and functions are substantially different in many tissues. Recent development of reliable antibodies to ER-beta has provided this first opportunity to test the hypothesis that the likelihood of malignant transformation in morphologically benign breast lesions can be accurately defined by the distribution and level of ER-beta expression relative to that of ER-alpha. Using a monoclonal antibody, ER-beta protein expression has been analyzed in 53 normal breasts and compared with a cohort of histologically distinct breast lesions of different prognostic risk (54 hyperplasia of usual type, 35 ductal carcinoma in situ, and 141 invasive cancers). All of these tissues were also assessed for ER-alpha. Expression of ER-beta protein was also analyzed in an additional spectrum of benign breast lesions with low or negligible risk of progression to malignancy. The median proportion of cells expressing ER-beta was highest in normal breast lobules (median 94.33%, interquartile range 78.25-99.00) but declined significantly through usual ductal hyperplasia (median 76.67, interquartile range 49.17-95.00, P = 0.002) and ductal carcinoma in situ (median 70.00, interquartile range 59.00-85.00, P = 0.009) to invasive cancer (median 60.00, interquartile range 50.00-80.00, P < 0.001). An appreciable proportion (33.81%) of ER-alpha-negative invasive cancers expressed ER-beta. A high but variable level of ER-beta expression occurred in the benign lesions. The data from the intact histologic tissues were evaluated with respect to the relative expression of ER-alpha and ER-beta in five mammary cell lines of different behavioral phenotype (MCF7, ZR-75, T47D, MDAMB231, HUMA121). The highly significant differences in expression and distinct tissue distributions of ER-alpha and ER-beta within the histologic lesions of defined risk, together with the data from the cell lines, support the original hypothesis that the tissue concentration, relative occurrence, and/or interaction of these two types of estrogen receptor may play an important role in modulating mammary tumorigenesis.     

Concurrent invasive ductal carcinoma and chronic lymphocytic leukemia manifesting as a collision tumor in breast

Collision tumors are rare clinical entities in which two histologically distinct tumor types show involvement in the same site. The occurrence of these tumors in the breast is extremely rare. Here, we present a case of a patient with both invasive ductal carcinoma and chronic lymphocytic leukemia in the breast. Wide excision with sentinel lymph node biopsy revealed palpably abnormal lymph nodes negative for breast carcinoma on frozen section. Histopathological examination of these lymph nodes showed extensive involvement by lymphoma and review of the breast specimen demonstrated the same lymphoma at the periphery of the ductal carcinoma. We review the literature and discuss possible etiologies for the dual presentation of both cancers.