1
|
Patuleia SIS, Moelans CB, Koopman J, van Steenhoven JEC, van Dalen T, van der Pol CC, Jager A, Ausems MGEM, van Diest PJ, van der Wall E, Suijkerbuijk KPM. Patient-centered research: how do women tolerate nipple fluid aspiration as a potential screening tool for breast cancer? BMC Cancer 2022; 22:705. [PMID: 35761221 PMCID: PMC9235076 DOI: 10.1186/s12885-022-09795-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Nipple fluid aspiration (NFA) is a technique to acquire nipple aspirate fluid (NAF), which is considered a rich source of breast-specific biomarkers. Originating directly from the mammary ducts, this liquid biopsy can offer insight into the process of carcinogenesis at its earliest stage and therefore could be of added value to the current imaging-based breast cancer screening tools. With that in mind, it is necessary to know how well NFA is tolerated. Aim To evaluate the participants’ tolerability of NFA compared to breast imaging screening methods and blood draws. Materials and methods Three cohorts of women underwent NFA: healthy women (n = 190), women diagnosed with breast cancer (n = 137) and women at high risk of developing breast cancer (n = 48). A 0–10 discomfort score of NFA, mammography, breast MRI and blood draws, was filled in at the study visits, which took place once or annually. Results The median discomfort rate of NFA was 1, which was significantly lower than the median discomfort of mammography and breast MRI (5 and 3, respectively, p < 0.001), but significantly higher than median discomfort for blood draws (0, p < 0.001). The great majority of women would undergo the procedure again (98%) and recommend it to others (97%). Conclusion This study shows that NFA was well tolerated by healthy women, women diagnosed with breast cancer and high-risk women. This makes NFA a feasible method to pursue as a potential future breast cancer early detection tool, based on resident biomarkers. Trial registration NL41845.041.12, NL57343.041.16 and NL11690.041.06 in trialregister.nl. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09795-8.
Collapse
|
2
|
Patuleia SIS, Suijkerbuijk KPM, van der Wall E, van Diest PJ, Moelans CB. Nipple Aspirate Fluid at a Glance. Cancers (Basel) 2021; 14:cancers14010159. [PMID: 35008326 PMCID: PMC8750428 DOI: 10.3390/cancers14010159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/20/2021] [Accepted: 12/26/2021] [Indexed: 11/21/2022] Open
Abstract
Simple Summary Nipple aspirate fluid (NAF) is a promising source of markers for detection of breast cancer. NAF can be acquired via the nipple by aspiration using a suction device, which is well tolerated by women. Future possible applications of biomarkers for breast cancer derived from NAF could be (1) as a detection tool to identify the initiation of the cancer development process, (2) as an additional tool next to imaging (mammography and breast magnetic resonance imaging) or (3) as a replacement tool for when imaging is not advisable for women, such as during pregnancy and breastfeeding. With this paper, we present a narrative review and perspectives of NAF research at a glance. Abstract Nipple aspirate fluid (NAF) is an intraductal mammary fluid that, because of its close proximity to and origin from the tissue from which breast cancer originates, is a promising source of biomarkers for early breast cancer detection. NAF can be non-invasively acquired via the nipple by aspiration using a suction device; using oxytocin nasal spray helps increase yield and tolerability. The aspiration procedure is generally experienced as more tolerable than the currently used breast imaging techniques mammography and breast magnetic resonance imaging. Future applications of NAF-derived biomarkers include their use as a tool in the detection of breast carcinogenesis at its earliest stage (before a tumor mass can be seen by imaging), or as a supporting diagnostic tool for imaging, such as when imaging is less reliable (to rule out false positives from imaging) or when imaging is not advisable (such as during pregnancy and breastfeeding). Ongoing clinical studies using NAF samples will likely shed light on NAF’s content and clinical potential. Here, we present a narrative review and perspectives of NAF research at a glance.
Collapse
Affiliation(s)
- Susana I. S. Patuleia
- Department of Pathology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (S.I.S.P.); (P.J.v.D.)
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (K.P.M.S.); (E.v.d.W.)
| | - Karijn P. M. Suijkerbuijk
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (K.P.M.S.); (E.v.d.W.)
| | - Elsken van der Wall
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (K.P.M.S.); (E.v.d.W.)
| | - Paul J. van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (S.I.S.P.); (P.J.v.D.)
| | - Cathy B. Moelans
- Department of Pathology, University Medical Center Utrecht, Utrecht University, 3508 GA Utrecht, The Netherlands; (S.I.S.P.); (P.J.v.D.)
- Correspondence:
| |
Collapse
|
3
|
Malik BH, Klock JC. Breast Cyst Fluid Analysis Correlations with Speed of Sound Using Transmission Ultrasound. Acad Radiol 2019; 26:76-85. [PMID: 29887398 PMCID: PMC6286231 DOI: 10.1016/j.acra.2018.03.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 03/14/2018] [Accepted: 03/27/2018] [Indexed: 11/20/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this work is to determine if the speed of sound value of a breast cyst can aid in the clinical management of breast masses. Breast macrocysts are defined as fluid-filled tissue masses >1 cm in diameter and are thought to be aberrations of normal development and involution, often associated with apocrine metaplasia. The benign natural history of breast cysts is well known, and it is important to obtain high specificity in breast imaging to avoid unnecessary biopsies in women who have benign diseases, particularly those with dense breast tissue. Transmission ultrasound is a tomographic imaging modality that generates high-resolution, 3D speed of sound maps that could be used to identify breast tissue types and act as a biomarker to differentiate lesions. We performed this study to investigate the microanatomy of macrocysts observed using transmission ultrasound, as well as assess the relationship of speed of sound to the physical and biochemical parameters of cyst fluids. MATERIALS AND METHODS Cyst fluid samples were obtained from 37 patients as part of a case-collection study for ultrasound imaging of the breast. The speed of sound of each sample was measured using a quantitative transmission ultrasound scanner in vivo. Electrolytes, protein, cholesterol, viscosity, and specific gravity were also measured (in the aspirated cyst fluid) to assess their relationship to the speed of sound values obtained during breast imaging. RESULTS We found positive correlations between viscosity and cholesterol (r = 0.71) and viscosity and total protein × cholesterol (r = 0.78). Additionally, we performed direct cell counts on cyst fluids and confirmed a positive correlation of number of cells with speed of sound (r = 0.74). The speed of sound of breast macrocysts, as observed using transmission ultrasound, correlated with the cytological features of intracystic cell clumps. CONCLUSION On the basis of our work with speed as a classifier, we propose a spectrum of breast macrocysts from fluid-filled to highly cellular. Our results suggest high-speed cysts are mature macrocysts with high cell counts and many cellular clumps that correlate with cyst microanatomy as seen by transmission ultrasound. Further studies are needed to confirm our findings and to assess the clinical value of speed of sound measurements in breast imaging using transmission ultrasound.
Collapse
Affiliation(s)
- Bilal H Malik
- QT Ultrasound Labs, 3 Hamilton Landing Suite 160, Novato, California 94949.
| | - John C Klock
- QT Ultrasound Labs, 3 Hamilton Landing Suite 160, Novato, California 94949
| |
Collapse
|
4
|
Exploration d’un syndrome kystique mammaire : recommandations. ACTA ACUST UNITED AC 2015; 44:970-9. [DOI: 10.1016/j.jgyn.2015.09.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 09/21/2015] [Indexed: 11/21/2022]
|
5
|
Rinaldi P, Ierardi C, Costantini M, Magno S, Giuliani M, Belli P, Bonomo L. Cystic breast lesions: sonographic findings and clinical management. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:1617-1626. [PMID: 20966473 DOI: 10.7863/jum.2010.29.11.1617] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE This article reviews basic sonographic findings for distinguishing cystic lesions of the breast. METHODS We describe sonographic features of simple and complicated cysts in comparison with complex masses and intracystic carcinomas. RESULTS We correlate cystic lesion appearances with histologic patterns and illustrate the diagnostic and therapeutic management of cystic breast lesions. CONCLUSIONS Sonography is a useful tool in distinguishing simple cysts from complicated cysts and complex masses of the breast.
Collapse
Affiliation(s)
- Pierluigi Rinaldi
- Department of Bioimaging and Radiological Sciences, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
6
|
Mannello F, Medda V, Smaniotto A, Tonti GA. Intracrinology of breast microenvironment: hormonal status in nipple aspirate fluid and its relationship to breast cancer. Expert Rev Endocrinol Metab 2009; 4:493-505. [PMID: 30736188 DOI: 10.1586/eem.09.28] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Breast cancer, a complex and multifactorial disease, is the most commonly diagnosed malignancy affecting women. Methods currently available for breast cancer detection have well-described limitations; in this respect, the intraductal approaches directly assess the microenvironment of the breast. Nipple aspirate fluid (NAF) can be noninvasively obtained from the breast in most women and represents a promising biological tool to assess metabolic, hormonal and molecular changes occurring in the cells lining the ducts, from which breast cancer arises. The aim of this review is to highlight the application of NAF studies in the field of biomarker discovery, which provide results useful for early detection and prevention of breast cancer risk; in fact, the analysis of NAF (mirroring the ductal-lobular microenvironment) is a reliable method for assessment of metabolic/hormonal pathways within the mammary gland, identifying biomolecular mechanisms of breast cancer initiation and progression. The intracrinology of breast microenvironment (i.e., hormonal status in NAF) may provide independent diagnostic/prognostic factors, highlighting the importance of early altered hormonal metabolism (e.g., aromatase, estrogen sulfotransferase and steroid sulfatase pathway) in relation to breast cancer initiation. The possible application of targeted therapies through the inhibition of intratumoral enzymes involved in steroid metabolism is also discussed. The intraductal approach to hormone analyses may provide a further panel of biomarkers providing clinical benefits and strengthening the armory against breast cancer.
Collapse
Affiliation(s)
- Ferdinando Mannello
- a Department of Biomolecular Sciences, Section of Clinical Biochemistry, Faculty of Sciences and Technologies, University 'Carlo Bo', Via O. Ubaldini 7, 61029 Urbino (PU), Italy.
| | - Virginia Medda
- b Department of Biomolecular Sciences, Section of Clinical Biochemistry, Faculty of Sciences and Technologies, University "Carlo Bo", Via O. Ubaldini 7, 61029 Urbino (PU), Italy
| | - Alessandra Smaniotto
- b Department of Biomolecular Sciences, Section of Clinical Biochemistry, Faculty of Sciences and Technologies, University "Carlo Bo", Via O. Ubaldini 7, 61029 Urbino (PU), Italy
| | - Gaetana A Tonti
- b Department of Biomolecular Sciences, Section of Clinical Biochemistry, Faculty of Sciences and Technologies, University "Carlo Bo", Via O. Ubaldini 7, 61029 Urbino (PU), Italy
| |
Collapse
|
7
|
Mannello F, Medda V, Tonti GA. Protein profile ana lysis of the breast microenvironment to differentiate healthy women from breast cancer patients. Expert Rev Proteomics 2009; 6:43-60. [DOI: 10.1586/14789450.6.1.43] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|
8
|
Burch JB, Walling M, Rush A, Hennesey M, Craven W, Finlayson C, Anderson BO, Cosma G, Wells RL. Melatonin and estrogen in breast cyst fluids. Breast Cancer Res Treat 2006; 103:331-41. [PMID: 17061046 DOI: 10.1007/s10549-006-9372-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Accepted: 08/10/2006] [Indexed: 12/21/2022]
Abstract
Increased breast cancer risks have been reported among women with gross cystic breast disease (GCBD), although the mechanism for this increase remains unexplained. Relationships between GCBD characteristics, breast cancer risk factors, and the biochemical composition and growth properties of 142 breast cyst fluid (BCF) samples were studied among 93 women with GCBD. Concentrations of melatonin, estrogen (17-beta-estradiol), dehydroepiandrosterone-sulfate (DHEA-S), epidermal growth factor (EGF), transforming growth factor beta (TGF-B1 and TGF-B2), sodium (Na), and potassium (K) were quantified in BCF samples, and human breast cancer cells (MCF-7) were treated with BCF in vitro. Patients were grouped according to BCF Na:K ratios previously linked with increased breast cancer risks (Na:K </= 3, Type 1), and mean concentrations of BCF constituents were compared with low risk (Na:K > 3, Type 2) and mixed cyst groups. Women with larger and more frequently occurring cysts had higher BCF estrogen and DHEA-S, and lower TGF-B1 levels. Women with Type 1 cysts had elevated BCF melatonin, estrogen, DHEA-S, and EGF, and lower concentrations of TGF-B2 compared to women with Type 2 cysts. BCF generally inhibited cell growth relative to serum-treated controls, consistent with previous studies. Melatonin and estrogen in BCF independently predicted growth inhibition and stimulation, respectively. Biological monitoring of BCF may help identify women with GCBD at greatest risk for breast cancer development.
Collapse
Affiliation(s)
- James B Burch
- Cancer Prevention and Control Program, Center for Colon Cancer Research, WJB Dorn Veterans Affairs Medical Center, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Mannello F, Tonti GAM, Papa S. Human gross cyst breast disease and cystic fluid: bio-molecular, morphological, and clinical studies. Breast Cancer Res Treat 2005; 97:115-29. [PMID: 16331347 DOI: 10.1007/s10549-005-9110-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Accepted: 10/26/2005] [Indexed: 11/25/2022]
Abstract
For more than one and a half century the cystic disease of the breast has been recognized as the most frequent female benign breast lesion. Although some conundrums and controversies exist about the relation between gross cysts and breast cancer, recent evidence suggests that the multidisciplinary study of gross cystic breast disease (GCBD) may be a powerful tool for predicting the natural history of the multifaceted gross cyst pathology. A lot of papers have been published on breast cyst fluids (BCF) concerning biochemical, hormonal and morphological aspects, demonstrating that the intracystic fluid contains a wide variety of components (such as ions, lipids, proteins, enzymes, growth factors and antigens) and suggesting that their profile provides additional knowledge on both physiopathology and etiologic pathways of human gross cystic breast disease. The aim of this overview is the critical evaluation of all data accumulated in the last thirty years, in order to highlight the utility of biochemical and epidemiological studies to identify gross cysts, if any, at higher breast cancer risk.
Collapse
Affiliation(s)
- Ferdinando Mannello
- Istituto di Istologia ed Analisi di Laboratorio, Università Studi Carlo Bo, Urbino (PU), Italy.
| | | | | |
Collapse
|
10
|
Klein P, Glaser E, Grogan L, Keane M, Lipkowitz S, Soballe P, Brooks L, Jenkins J, Steinberg SM, DeMarini DM, Kirsch I. Biomarker assays in nipple aspirate fluid. Breast J 2001; 7:378-87. [PMID: 11843848 DOI: 10.1046/j.1524-4741.2001.07601.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The noninvasive technique of nipple aspiration as a potential source of biomarkers of breast cancer risk was evaluated. The feasibility of performing mutagenesis assays, amplifying DNA, and performing protein electrophoresis on nipple aspirate fluid was explored. A tool was developed to measure the level of discomfort, if any, from this procedure. Twenty-five healthy women (20 premenopausal and 5 postmenopausal) were enrolled. Fluid was obtained using a modified breast pump. Premenopausal women were scheduled for four to six weekly aspirations, and postmenopausal women were scheduled for one to two weekly aspirations. Mutagenesis assays were performed using the Salmonella (Ames) assay. DNA amplification of several microsatellite regions was carried out using polymerase chain reaction. Protein was quantified, and two-dimensional protein electrophoresis was performed. Overall, fluid was obtained from 80% of the women, and the level of discomfort was minimal. Acid hydrolysis of one sample resulted in mutagenicity; all six nonhydrolyzed samples were not mutagenic. The ability to amplify DNA ranged from 34% to 96%, depending on length of the microsatellite region examined. The average protein concentration was 71 microg/mL. Two-dimensional protein electrophoresis was successfully performed on samples from two subjects. Nipple aspiration is a simple technique and is easily learned and well tolerated, which yields a reagent useful for a variety of investigations. This technique may facilitate the identification and application of biomarkers for future breast cancer risk assessment and chemopreventive protocols.
Collapse
Affiliation(s)
- P Klein
- Genetics Branch, CCR National Cancer Institute, Bethesda, MD 20889, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Malatesta M, Mannello F, Sebastiani M, Gazzanelli G. Differential distribution of soluble and complexed forms of prostate-specific antigen in cyst fluids of women with gross cystic breast disease. J Clin Lab Anal 2001; 15:81-6. [PMID: 11291110 PMCID: PMC6807965 DOI: 10.1002/jcla.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Gross cystic breast disease (GCBD) is the most common benign disease of the human female breast, and patients with GCBD have an increased risk of breast cancer. The aim of this study was to evaluate the distribution inside apocrine cells and in breast cyst fluids aspirated from gross cysts of prostate-specific antigen (PSA) molecular forms, and to correlate the different intracystic PSA profiles to the subpopulations of gross cysts. Type I cysts showed a median value of 0.71 microg/L of total PSA and 0.32 g/L of ACT, significantly different to that of Type II cysts (Wilcoxon P < 0.001). Although large excesses of ACT were detected in all samples, BCF samples and apocrine cells from Type I gross cysts contained about 70% of free PSA, compared to the higher amounts of complexed PSA found in Type II gross cysts. We demonstrate that in apocrine/secretive Type I breast gross cysts the serine protease PSA was mainly present in its free form, in contrast to a major proportion of complexed PSA found in flattened/transudative Type II cysts. Our results are consistent with the notion that a prolonged exposure of apocrine breast cells lining the Type I gross cysts to the proteolytic activity of PSA could be involved in the etiopathogenesis of GCBD.
Collapse
Affiliation(s)
- Manuela Malatesta
- Istituto di Istologia & Analisi di Laboratorio, Libera Università, Facoltà di Scienze Matematiche Fisiche e Naturali, Urbino, Italy
| | - Ferdinando Mannello
- Istituto di Istologia & Analisi di Laboratorio, Libera Università, Facoltà di Scienze Matematiche Fisiche e Naturali, Urbino, Italy
| | | | - Giancarlo Gazzanelli
- Istituto di Istologia & Analisi di Laboratorio, Libera Università, Facoltà di Scienze Matematiche Fisiche e Naturali, Urbino, Italy
| |
Collapse
|
12
|
Malatesta M, Mannello F, Bianchi G, Sebastiani M, Gazzanelli G. Biochemical and ultrastructural features of human milk and nipple aspirate fluids. J Clin Lab Anal 2001; 14:330-5. [PMID: 11138618 PMCID: PMC6807916 DOI: 10.1002/1098-2825(20001212)14:6<330::aid-jcla14>3.0.co;2-p] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Breast duct epithelium produces, secretes, and metabolises several biologically important compounds, which are found in breast secretions obtained in physiologic and pathologic conditions (milk and nipple aspirate fluids, respectively). In order to preliminarily evaluate the ultrastructural morphology of the cells found in Type II nipple aspirate fluids (NAF) and correlate it with the biochemical profile of the extracellular fluid present in these breast secretions and in human milk, we analyzed 72 NAFs from nonlactating premenopausal women affected by various breast diseases and 10 normal milk samples. Although several constitutive proteins were detected in all samples examined, the preliminary biochemical analyses and electrophoretic profiles revealed characteristic behaviours for several biologic constituents, suggesting a possible basic mechanism of production by breast epithelial cells during both physiologic and pathologic conditions. The ultrastructural analysis of milk cellular components give preliminary evidence of the apocrine secretion mechanism peculiar of breast gland, whereas Type II NAF cells appeared as biosynthetically active cells, showing a possible modified secretion mechanism. Our multidisciplinary approach seems to support the hypothesis that cellular and biochemical behaviour of Type II NAF may be an useful tool to identify aberrated breast epithelial cells in nonlactating women that might be prone to premalignant transformation.
Collapse
Affiliation(s)
- Manuela Malatesta
- Istituto di Istologia ed Analisi di Laboratorio, Facoltà di Scienze M.F.N., Università Studi, Urbino, Italy
| | - Ferdinando Mannello
- Istituto di Istologia ed Analisi di Laboratorio, Facoltà di Scienze M.F.N., Università Studi, Urbino, Italy
| | | | | | - Giancarlo Gazzanelli
- Istituto di Istologia ed Analisi di Laboratorio, Facoltà di Scienze M.F.N., Università Studi, Urbino, Italy
| |
Collapse
|
13
|
Mannello F, Malatesta M, Sebastiani M, Battistelli S, Gazzanelli G. Molecular Forms and Ultrastructural Localization of Prostate-specific Antigen in Nipple Aspirate Fluids,. Clin Chem 1999. [DOI: 10.1093/clinchem/45.12.2263] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ferdinando Mannello
- Istituto di Istologia & Analisi di Laboratorio, Facoltà di Scienze Matematiche, Fisiche e Naturali, Università Studi, Via E. Zeppi, 61029 Urbino-PS, Italy
| | - Manuela Malatesta
- Istituto di Istologia & Analisi di Laboratorio, Facoltà di Scienze Matematiche, Fisiche e Naturali, Università Studi, Via E. Zeppi, 61029 Urbino-PS, Italy
| | | | - Serafina Battistelli
- Istituto di Istologia & Analisi di Laboratorio, Facoltà di Scienze Matematiche, Fisiche e Naturali, Università Studi, Via E. Zeppi, 61029 Urbino-PS, Italy
| | - Giancarlo Gazzanelli
- Istituto di Istologia & Analisi di Laboratorio, Facoltà di Scienze Matematiche, Fisiche e Naturali, Università Studi, Via E. Zeppi, 61029 Urbino-PS, Italy
| |
Collapse
|
14
|
Malatesta M, Mannello F, Sebastiani M, Cardinali A, Marcheggiani F, Renò F, Gazzanelli G. Ultrastructural characterization and biochemical profile of human gross cystic breast disease. Breast Cancer Res Treat 1998; 48:211-9. [PMID: 9598868 DOI: 10.1023/a:1005932915429] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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.
Collapse
Affiliation(s)
- M Malatesta
- Istituto di Istologia ed Analisi di Laboratorio, Università degli Studi, Urbino, Italy
| | | | | | | | | | | | | |
Collapse
|