Abstract
Juvenile papillomatosis (JP) is a benign proliferative disease of the breast affecting young women. Some patients with JP develop breast carcinoma. We recently treated and followed a case of JP in a 16-year-old female, and studied its immunohistochemical characteristics. The patient noticed a small tumor, 5 mm in diameter, in the periareolar region on the medial side of the right breast. She underwent an excisional biopsy and pathology demonstrated JP. However, 6 months later, two new lesions were discovered by routine echogram examination, and were later excised. Immunohistochemistry demonstrated that the JP tumors were negative for estrogen receptor, but positive for progesterone receptor, epidermal growth factor receptor and erbB-2. In addition, tests for p53 were negative and Rb protein was normally expressed. Immunohistochemical analysis suggested that an abnormality in estrogen receptor is important in the pathogenesis of JP, and that the patient had a relatively high risk of developing breast carcinoma, since her JP is multicentric and recurrent. The present study also suggests that immunohistochemical pathology may be beneficial in assessing the malignant potential of JP.
Similar content being viewed by others
Abbreviations
- EGF:
-
Epidermal growth factor
- EGF-R:
-
EGF receptor
- ER:
-
Estrogen receptor
- JP:
-
Juvenile papillomatosis
- PR:
-
Progesterone receptor
- pRb:
-
Rb protein
Reference
Rosen PP, Cantrell B, Mullen DL,et al: Juvenile papillomatosis (Swiss cheese disease) of the breast.Am J Surg Pathol 4:3–12, 1980.
Kiaer HW, Kiaer WW, Linell F,et al: Extreme duct papillomatosis of the juvenile breast.Acta Pathol Microbiol Immunol Scand [A] 87A:353–359, 1979.
Bazzocchi F, Santini D, Martinelli G,et al: Juvenile papillomatosis (epitheliosis) of the breast; A clinical and pathologic study of 13 cases.Am J Clin Pathol 86: 745–748, 1986.
Rosen PP, Holmes G, Lesser MI,et al: Juvenile papillomatosis and breast carcinoma.Cancer 55:1345–1352, 1985.
Sund BS, Topstad TK, Nesland JM: A case of juvenile papillomatosis of the male breast.Cancer 70:126–128, 1992.
Rosen PP, Lyngholm B, Kinne DW,et al: Juvenile papillomatosis of the breast and family history of breast carcinoma.Cancer 49:2591–2595, 1982.
Rosen PP, Kimmel M: Juvenile papillomatosis of the breast; A follow-up study of 41 patients having biopsies before 1979.Am J Clin Pathol 93:599–603, 1990.
Tokunaga M, Wakimoto J, Muramoto Y,et al: Juvenile secretory carcinoma and juvenile papillomatosis.Jpn J Clin Oncol 15:457–465, 1985.
Morimoto T, Fukutomi T, Nanasawa T,et al: Juvenile intraductal papilloma; A case report.Jpn J Breast Cancer 8:290–292, 1993.
Nonomura A, Kimura A, Mizukami Y,et al: Secretory carcinoma of the breast associated with juvenile papillomatosis in a 12-year-old girl; A case report.Acta Cytol 39:569–576, 1995.
Nakata N, Tsujimoto F, Ohsugi F,et al: Two cases of juvenile multiple papillomatosis of the breast.Jpn J Clin Radiol 40:617–620, 1995.
Vojtesek B, Bartek J, Midgley CA,et al: An immunochemical analysis of the human nuclear phosphoprotein p53; New monoclonal antibodies and epitope mapping using recombinant p53.J Immonol Methods 151:237–244, 1992.
Shi SR, Key ME, Kalra KL: Antigen retrieval in formalin-fixed, paraffin-embedded tissues; An enhancement method for immunohistochemical staining based on microwave oven heating of tissue sections.J Histochem Cytochem 39:741–748, 1991.
Cunnungham JM, Ingle JN, Jung SH,et al: p53 gene expression in node-positive breast cancer; Relationship to DNA ploidy and prognosis.J Natl Cancer Inst 86:1871–1873, 1994.
Geradts J, Wilson PA: High frequency of aberrant pl6NK4A expression in human breast cancer.Am J Pathol 149:15–20, 1996.
Umekita Y, Enokizono N, Sagara Y,et al: Immunohistochemical studies on oncogene products (EGF-R, c-erbB-2) and growth factors (EGF, TGF-alpha) in human breast cancer; Their relationship to oestrogen receptor status, histologcal grade, mitotive index and nodel status.Virchows Arch [A] 420:345–351, 1992.
van Agthoven T, Timmermans M, Foekens JA,et al: Differential expression of estrogen, progesterone, and epidermal growth factor receptor in normal, benign, and malignant human breast tissues using dual staining immunohistochemistry.Am J Pathol 144:1238–1246, 1994.
Horwitz KB, McGuire WL: Estrogen control of progesterone receptor in human breast cancer; Correlation with nuclear processing of estrogen receptor.J Biol Chem 253:2223–2228, 1978.
Bevilacqua P, Gasparini G, Fior SD,et al: Immunocytochemical determination of epidermal growth factor receptor with monoclonal EGFR1 antibody in primary breast cancer patients.Oncology 47:313–317, 1990.
Klijn JG, Look MP, Portengen H,et al: The prognostic value of epidermal growth factor receptor (EGF-R) in primary breast cancer; Result of a 10 year follow-up study.Breast Cancer Res Treat 29:73–83, 1994.
Gompel A, Martin A, Simon P,et al: Epidermal growth factor receptor and c-erbB-2 expression in normal breast tissue during the menstrual cycle.Breast Cancer Res Treat 38:227–235, 1996.
Dittadi R, Donisi PM, Brazzale A,et al: Epidermal growth factor receptor in breast cancer; Comparison with non-malignant breast tissue.Br J Cancer 67:7–9, 1993.
Paik S, Hazan R, Fisher ER,et al: Pathologic findings from the National Surgical Adjuvant Breast and Bowel Project; Prognostic significance of C-ERBB2 protein overexpression in primary breast cancer.J Clin Oncol 8:103–112, 1990.
Kallioniemi OP, Holli K, Visakorpi T,et al: Association of c-erbB-2 protein overexpression with high rate of cell proliferation, increased risk of visceral metastasis and poor long-term survival in breast cancer.Int J Cancer 49: 650–655, 1991.
Iglehart JD, Kraus MH, Langton BC,et al: Increased erbB-2 gene copies and expression in multiple stages of breast cancer.Cancer Res 50:6701–6707, 1990.
Allred DC, Clark GM, Elledge R,et al: Association of p53 protein expression with tumor cell proliferation rate and clinical outcome in node-negative breast cancer.J Natl Cancer Inst 85:200–206, 1993.
Lipponen P, Ji H, Aaltomaa S,et al: p53 protein expression in breast cancer as related to histopathological cheracteristics and prognosis.Int J Cancer 55:51–56, 1993.
Thor AD, Moore DH II, Edgerton SM,et al: Accumulation of p53 tumor suppressor gene protein; An independent marker of prognosis in breast cancers.J Natl Cancer Inst 84:845–855, 1992.
Sjogren S, Inganas M, Norberg T,et al: The p53 gene in breast cancer; Prognostic value of complementary DNA sequencing versus immunohistochemistry.J Natl Cancer Inst 88:173–182, 1996.
Boschman CR, Stryker S, Reddy JK,et al: Expression of p53 protein in precursor lesions and adenocarcinoma of human pancreas.Am J Pathol 145:1291- 1295, 1994.
Zhang SY, Ruggeri B, Agarwal P,et al: Immunohistochemical analysis of p53 expression in human pancreatic carcinomas.Arch Pathol Lab Med 101: 684- 688, 1994.
DiGiuseppe JA, Hruban RH, Goodman SN,et al: Overexpression of p53 protein in adenocarcinoma of the pancreas.Am J Clin Pathol 101:684–688, 1994.
Pietilainen T, Lipponen P, Aaltomaa S,et al: Expression of retinoblastoma gene protein (Rb) in breast cancer as related to established prognostic factors and survival.Eur J Cancer 31:329–333, 1995.
Author information
Authors and Affiliations
About this article
Cite this article
Nio, Y., Minari, Y., Hirahara, N. et al. A case of multiple juvenile papillomatosis of the breast and its immunohistochemical pathology. Breast Cancer 5, 187–193 (1998). https://doi.org/10.1007/BF02966694
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02966694