Abstract
Human gross cystic breast disease is a benign condition affecting about 7–10% of adult women occurring with the highest incidence in the premenopausal decade. Although breast cysts do not represent a preneoplastic condition per se, several studies indicate an increased breast cancer risk in women affected by this pathology. In this report we study 115 breast cystic fluid samples obtained by needle-aspiration from women with gross cystic breast disease. The samples were analysed biochemically and the cells contained therein were observed at the electron microscope. According to their biochemical profiles, the cysts were subdivided into three types: Type I, showing a Na/K ratio < 0.5 and a typical protein content; Type II, showing a Na/K ratio >10 and a protein content quite similar to plasma; Type III, showing a Na/K ratio between 1 and 7 and an intermediate protein content. The electron microscopic examination demonstrated that Type I cystic fluid cells exhibit morphological features typical of actively synthesising and secreting cells, while the characteristics of Type II cells indicate a low metabolic activity. Type III cells have characteristics typical of both Type I and Type II cells, thereby confirming the intermediate nature of this cyst type. We hypothesise that these cyst types could represent different developmental stages of a structural evolution pathway, during which the biosynthetically active 'apocrine stage' would be the key step to cell neoplastic transformation.
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Haagensen CD: Disease of the Breast. WB Saunders & Co., Philadelphia, 1986
Ciatto S, Biggeri A, Rosselli Del Turco M, Bartoli D, Iossa A: Risk of breast cancer subsequent to proven gross cystic disease. Eur J Cancer 26: 555–557, 1990
Bundred NJ, West RR, Dowd JO, Mansel RE, Hughes LE: Is there an increased risk of breast cancer in women who have had a breast cyst aspirated? Br J Cancer 64: 953–955, 1991
Page DL, van der Zwaag R, Rogers LW, Williams LT, Walker WE, Hartman WH: Relationship between component parts of fibrocystic disease complex and breast cancer. J Natl Cancer Inst 61: 1055–1058, 1978
Dupont WD, Page DL: Risk factors for breast cancer in women with proliferative breast disease. N Engl J Med 312: 146–148, 1985
Dixon JM, Lumsden AB, Miller WR: The relationship of cyst type to risk factors for breast cancer and the subsequent development of breast cancer in patients with breast cystic disease. Eur J Cancer Clin Oncol 21: 1047–1050, 1985
Naldoni C, Costantini M, Dogliotti L, Bruzzi P, Bucchi L, Buzzi G, Torta M, Angeli A: Association of cyst type with risk factors for breast cancer and relapse rate in women with gross cystic disease of the breast. Cancer Res 52: 1791–1795, 1992
Angeli A, Dogliotti L, Naldoni C, Orlandi F, Puligheddu B, Caraci P, Bucchi L, Torta M, Bruzzi P: Steroid biochemistry and categorization of breast cyst fluid: relation to breast cancer risk. J Steroid Biochem Mol Biol 49: 333–339, 1994
Mannello F, Troccoli R: Improved electrophoretic map of breast cyst fluid proteins. Cancer Detect Prev 16: 107–112, 1992
Molina R, Filella X, Herranz M, Prats M, Velasco A, Zanon G, Martinez-Osaba MJ, Ballesta AM: Biochemistry of cyst fluid in fibrocystic disease of the breast. Approach to classification and understanding of the mechanism of formation. Ann NY Acad Sci USA 586: 29–42, 1990
Sartorius O: The biochemistry of breast cyst fluids and duct secretions. Breast Cancer Res Treat 35: 255–266, 1995
Rosner W, Khan MS, Breed CN, Fleisher M, Bradlow HL: Plasma steroid binding proteins in the cystic disease of the breast. J Clin Endocrinol Metab 61: 200–204, 1985
Zanardi S, Valenti G, Torrisi R, Maisto L, Nicolò G, Barreca A, Minuto F, Boccardo F: Identification of breast cyst subpopulations: biochemical and morphological features. Cancer Detect Prev 15: 273–276, 1991
Enriori CL, Novelli JE, Cremona MC, Hirsig RJP, Enriori PJ: Biochemical study of cyst fluid in human breast cystic disease: a review. Breast Cancer Res Treat 24: 1–8, 1992
Bradlow HL, Fleisher M, Breed CN, Chasalow FI: Biochemical classification of patients with gross cystic breast disease. Ann NY Acad Sci 586: 12–16, 1990
Dogliotti L, Orlandi F, Caraci P, Puligheddu B, Torta M, Angeli A: Biochemistry of breast cyst fluid: an approach to understanding intercellular communication in the terminal duct lobular units. Ann NY Acad Sci USA 586: 17–28, 1990
Dixon JM, Miller WR, Scott WN: The morphological basis of human breast cyst populations. Br J Surg 70: 604–606, 1983
Nagy GK, DeCiero GJ, Pomerantz SN: Intracytoplasmic eosinophilic inclusion bodies in benign breast cyst fluids. Acta Cytol 30: 45–47, 1986
Ciatto S, Cariaggi P, Bulgaresi P: The value of routine cytologic examination of breast cyst fluids. Acta Cytol 31: 301–304, 1987
Beccati D, Grilli N, Schincaglia P, Naldoni C, Tavolazzi L, Ranaldi R, Dogliotti L, Torta M, Angeli A: Apocrine cells in beast cyst fluid and their relationship to cyst type: a morphometric study. Eur J Cancer Clin Oncol 24: 597–602, 1988
Nagy GK, Jacobs JB, Mason-Savas A, Pomerantz SN, De-Ciero GJ: Intracytoplasmic eosinophilic inclusion bodies in breast cyst fluids are giant lysosomes. Acta Cytol 33: 99–103, 1989
Mannello F, Bocchiotti GD, Troccoli R, Gazzanelli G: Lipid-associated sialic acid levels in human breast cyst fluid. Breast Cancer Res Treat 24: 167–171, 1992
Hutter RVP: Goodbye to fibrocystic disease. N Engl J Med 312: 179–180, 1985
Mannello F, Bocchiotti GD, Bianchi G, Marcheggiani F, Gazzanelli G: Quantification of prostate-specific antigen immunoreactivity in human breast cyst fluids. Breast Cancer Res Treat 38: 247–252, 1996
Mannello F, Biagioni S, Stella C, Marcheggiani F, Artico M, Cerroni L, Terzano C, Battistelli S, Troccoli R: Lactate dehydrogenase isoenzyme patterns and cation levels in human breast gross cyst fluids. Clin Chim Acta 169: 91–99, 1987
Mannello F, Biagioni S, Stella F, Cerroni L, Stella C, Troccoli R: Alpha-1-antitrypsin, transferrin, alkaline phosphatase, phosphohexose isomerase and gammaglutamyltransferase in breast cyst fluids. Tumori 71: 135–140, 1985
Mannello F, Bocchiotti GD, Pignatti Morano F, Fratepietro LM, Gazzanelli G: Lipids status in human breast cyst fluids. Cancer Lett 98: 137–143, 1996
Fawcett DW: The Cell. WB Saunders & Co., Philadelphia, 1981
Simpson JF, Page DL: Loss of expression of fodrin (a structural protein) in cystic changes of human breast. Lab Invest 68: 537–540, 1993
Mannello F, Sebastiani M, Amati S, Gazzanelli G: Conjugated bile acids in breast cyst fluids: relationship to cation-related cyst subpopulations. Cancer Lett (in press), 1997
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Malatesta, M., Mannello, F., Sebastiani, M. et al. Ultrastructural characterization and biochemical profile of human gross cystic breast disease. Breast Cancer Res Treat 48, 211–219 (1998). https://doi.org/10.1023/A:1005932915429
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DOI: https://doi.org/10.1023/A:1005932915429