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Defining invasion in breast cancer: the role of basement membrane
  1. Suzan F Ghannam1,2,3,
  2. Catrin Sian Rutland3,4,
  3. Cinzia Allegrucci3,4,
  4. Nigel P Mongan4,5,
  5. Emad Rakha1,3,6
  1. 1Division of cancer and stem cells, school of Medicine, University of Nottingham, Nottingham, UK
  2. 2Histology and Cell Biology, Suez Canal University Faculty of Medicine, Ismailia, Egypt
  3. 3Nottingham Breast Cancer Research Centre, Biodiscovery Institute, University of Nottingham, Nottingham, UK
  4. 4School of Veterinary Medicine and Sciences, University of Nottingham, Nottingham, UK
  5. 5Department of Pharmacology, Weill Cornell Medicine, New York, New York, USA
  6. 6Histopathology,school of Medicine, University of Nottingham School of Medicine, Nottingham, UK
  1. Correspondence to Professor Emad Rakha, Histopathology, University of Nottingham School of Medicine, Nottingham NG5 1PB, UK; mrzear1{at}exmail.nottingham.ac.uk

Abstract

Basement membrane (BM) is an amorphous, sheet-like structure separating the epithelium from the stroma. BM is characterised by a complex structure comprising collagenous and non-collagenous proteoglycans and glycoproteins. In the breast, the thickness, density and composition of the BM around the ductal lobular system vary during differing development stages. In pathological conditions, the BM provides a physical barrier that separates proliferating intraductal epithelial cells from the surrounding stroma, and its absence or breach in malignant lesions is a hallmark of invasion and metastases. Currently, diagnostic services often use special stains and immunohistochemistry (IHC) to identify the BM in order to distinguish in situ from invasive lesions. However, distinguishing BM on stained sections, and differentiating the native BM from the reactive capsule or BM-like material surrounding some invasive malignant breast tumours is challenging. Although diagnostic use of the BM is being replaced by myoepithelial cell IHC markers, BM is considered by many to be a useful marker to distinguish in situ from invasive lesions in ambiguous cases. In this review, the structure, function and biological and clinical significance of the BM are discussed in relation to the various breast lesions with emphasis on how to distinguish the native BM from alternative pathological tissue mimicking its histology.

  • BREAST
  • Breast Neoplasms
  • CARCINOMA
  • COLLAGEN

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Footnotes

  • Handling editor Cheok Soon Lee.

  • Contributors SFAG and ER planned the review. SFAG wrote the manuscript. CR, CA, NM and ER reviewed and amended the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.