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

Abstract

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.

A Clinicopathological Study of cd34 Antigen Expression in Benign and Malignant Breast Lesions

“…This was similar to the findings of various researchers earlier [11][12][13][14][15][16][17][18][19][20][21][22].…”

“…CD34-positive stromal cells are also distributed in various normal organs including salivary gland, thyroid gland, tonsil, stomach, colon, uterus, Fallopian tube and testis [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Several studies have been conducted to investigate the distribution of CD34-positive stromal cells in neoplasms of various organs including salivary gland, stomach, colorectal tissue, breast, pancreas and uterine cervix .…”

“…In our study diffuse CD34 expression was seen in the interlobular as well as intralobular stroma of the normal breast (Figure 1). However, the origin of these stromal cells remains controversial with some researchers advocating that CD34+ fibroblasts are present in stroma since birth [11], while others are of the view that they are derived from blood borne fibrocytes [21]. Some investigators have reported that CD34 positive stromal cells disappear in the stroma of invasive ductal carcinoma (IDC) of the breast .…”

“…This study aimed to determine whether loss of CD34 is specific for invasive disease in the breast also (as has already been proved in other organs). An indication to this conclusion has been provided by some earlier researchers [11][12][13][14][15][16][17][18][19][20][21][22]. Bucala R et al also postulated that since CD34+ fibrocytes are capable of collagen I and collagen III synthesis, it seems to be likely that this cell type may be involved in the process of stromal remodeling in breast cancer [23].…”

Telocytes of the mammary gland stroma

“…A recent study [6] was focused upon CD34-positive "fibrocytes" of the MG stroma. It was evaluated there the stromal loss of CD34 expression and acquisition of smooth muscle actin phenotype as a condition for invasiveness of breast carcinoma.…”