Journal Article

Variable Stromal Periductular Expression of CD34 and Smooth Muscle Actin (SMA) in Intraductal Carcinoma of the Breast

Noël, Jean-Christophe, Catteau, Xavier, Simon, Philippe, Vanhaeverbeek, Michel

2013

Overview

In breast carcinoma, the stromal loss of CD34 expression and acquisition of SMA myofibroblastic features may constitute a prerequisite for tumor invasiveness. However, this hypothesis remains controversial, with some authors describing the loss of CD34 fibrocytes in the absence of SMA myofibroblastic-like cells in the stroma of invasive carcinoma. Others have also described the disappearance of CD34 fibrocytes from in situ carcinoma. To clarify this issue, we compared the distribution of CD34 fibrocytes and SMA reactive myofibroblasts between stromal areas of tumor-free mammary tissue, ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC). In addition to 28 IDC, 300 normal duct-lobular units and 600 ducts with DCIS (158 low-grade, 266 intermediate, and 176 high-grade) were scored. The relationships between staining patterns and different histological features (grade of DCIS and presence or absence of necrosis) were compared. Loss of CD34 expression and acquisition of SMA expression were more frequent in high-grade in situ lesions than in intermediate and low-grade lesions (p<0.001). When necrosis was found in association with grade 2 or 3 DCIS, the decrease in CD34 expression was higher than in lesions without necrosis and that independently of the grade of DCIS (p<0.05). Necrosis did not appear to play a significant role in the expression of SMA (p = 0.35). In all cases, the stroma of invasive carcinomas showed a complete loss of CD34 fibrocytes. Future research on both CD34 fibrocytes and mechanisms stromal changes are essential in the future and may potentially lead to new treatment approaches.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Actin / Actins - genetics / Actins - metabolism / Antigens / Antigens, CD34 - genetics / Antigens, CD34 - metabolism / Biopsy / Breast cancer / Breast carcinoma / Breast Neoplasms - genetics / Breast Neoplasms - pathology / Carcinoma in Situ - genetics / Carcinoma in Situ - pathology / Carcinoma, Intraductal, Noninfiltrating - genetics / Carcinoma, Intraductal, Noninfiltrating - pathology / Case-Control Studies / CD34 antigen / Consent / Development and progression / Extracellular matrix / Female / Fibroblasts / Gangrene / Gene Expression / Genetic aspects / Humans / Invasiveness / Lesions / Lymphatic system / Mammography / Medicine / Muscles / Myofibroblasts - metabolism / Myofibroblasts - pathology / Necrosis / Necrosis - genetics / Necrosis - pathology / Neoplasm Grading / Neoplasm Invasiveness / Pathology / Physiological aspects / Quality / Smooth muscle / Stroma / Stromal Cells - metabolism / Stromal Cells - pathology / Tumors