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Bedeutung des „Normalgewebes“ in der Brustkrebsentstehung

Neue Vorstellungen zur frühen Pathogenese des Mammakarzinoms

The significance of “normal tissue” in the development of breast cancer: new concepts of early carcinogenesis

  • Schwerpunkt: Mammapathologie
  • Published:
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Zusammenfassung

Die molekularbiologischen Abläufe in der frühen Pathogenese des Mammakarzinoms sind nur in Ansätzen bekannt. Speziell die Einschätzungen zu postulierten Vorläuferläsionen des invasiven Mammakarzinoms, wie der duktalen Hyperplasie und dem duktalen In-situ-Karzinom, werden bezüglich ihrer Pathogenese und Biologie kontrovers diskutiert. Neuere Forschungsergebnisse zu biologischen Regulationsmechanismen und genetischen Veränderungen im morphologisch unauffälligen, normalen Brustdrüsengewebe geben einen fundierten Anlass zu einer Neuinterpretation der gängigen Progressionsmodelle des invasiven Mammakarzinoms. Speziell die Entdeckung von genetischen Alterationen im normalen, tumorfreien Brustdrüsengewebe stellt die bisher postulierten Verwandtschaftsverhältnisse zwischen den invasiven und präinvasiven Mammakarzinomen auf der einen Seite und benignen, proliferativen duktalen Mammaläsionen auf der anderen Seite in Frage. Gestützt werden diese Zweifel zudem durch die Beschreibung von verschiedenen Zellkompartimenten, einschließlich eines „Progenitorzellkompartiments“ mit unterschiedlichen Zytokeratinexpressionsmustern und Parallelen dieser Expressionsmuster mit bekannten oder postulierten Vorstufen des Mammakarzinoms wie auch des invasiven Mammakarzinoms. Ziel dieser Arbeit ist, eine Übersicht über die neuesten Entwicklungen in der Mammapathologie zu geben und Konsequenzen für ein in Bewegung befindliches Verständnis zur Pathogenese des Mammakarzinoms aufzuzeichnen.

Abstract

Only little information on the primary molecularbiological events involved in early breast is available. In particular, the definition of postulated precursor lesions of invasive breast cancer, such as ductal hyperplasia or ductal carcinoma in situ, is under an intense, controversial discussion in terms of pathogenesis and tumor biology. The most recent research on biological regulation mechanisms and genetic alterations in morphologically normally appearing breast tissue give rise for a reinterpretation for the most common progression models of breast cancer. The detection of genetic alterations within normal breast tissue in particular challenges the commonly postulated relationship between invasive and in situ breast carcinomas on the one hand, and benign, proliferative breast lesions on the other. The concerns about these relationship are further supported by the description of different cellular compartments within the normal female breast, including a “progenitor cell compartment” with different cytokeratin expression patterns, which can be transferred towards well known or suspected precursor lesions of invasive and in situ breast cancer. The aim of this manuscript is to provide an overview of the most recent results and developments in breast pathology, and to describe the consequences of our changing understanding of breast carcinogenesis.

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  1. Gerhard-Domagk-Institut für Pathologie, Institut für Klinische Chemie und Laboratoriumsmedizin, Westfälische Wilhelms-Universität, Domagkstraße 17, 48149, Münster

    H. Bürger, C. Kersting, D. Hungermann, T. Decker & W. Böcker

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  1. H. Bürger
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  2. C. Kersting
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  3. D. Hungermann
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Correspondence to H. Bürger.

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Bürger, H., Kersting, C., Hungermann, D. et al. Bedeutung des „Normalgewebes“ in der Brustkrebsentstehung. Pathologe 27, 319–325 (2006). https://doi.org/10.1007/s00292-006-0857-7

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  • DOI: https://doi.org/10.1007/s00292-006-0857-7

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