Defining invasion in breast cancer: the role of basement membrane

Ghannam, Suzan F; Rutland, Catrin Sian; Allegrucci, Cinzia; Mongan, Nigel P; Rakha, Emad

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.

Citation

Ghannam, S. F., Rutland, C. S., Allegrucci, C., Mongan, N. P., & Rakha, E. (2022). Defining invasion in breast cancer: the role of basement membrane. Journal of Clinical Pathology, https://doi.org/10.1136/jcp-2022-208584

• Journal Article Type: Review
• Acceptance Date: Oct 1, 2022
• Online Publication Date: Oct 17, 2022
• Publication Date: Oct 17, 2022
• Deposit Date: Oct 28, 2022
• Publicly Available Date: Nov 2, 2022
• Journal: Journal of Clinical Pathology
• Print ISSN: 0021-9746
• Electronic ISSN: 1472-4146
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1136/jcp-2022-208584
• Keywords: CARCINOMA, Breast Neoplasms, BREAST, COLLAGEN
• Public URL: https://nottingham-repository.worktribe.com/output/12900543
• Publisher URL: https://jcp.bmj.com/content/early/2022/10/17/jcp-2022-208584