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Structural, Antigenic, and Biological Characteristics of Precancerous Mastopathy¹

Department of Pathology, New York Medical College, New York, New York 10029

A biologically significant relationship between precancerous mastopathy (PCM), in situ carcinoma (ISC), and invasive breast carcinoma is evidenced by the following: (a) PCM and ISC are commonly associated with each other and with invasive breast cancer; (b) Stage 0 PCM and ISC are both associated with an increased risk of subsequent breast cancer; (c) patients with Stage 0 PCM and ISC are more similar to invasive breast cancer patients than to patients with normotypic breast lesions in regard to family history of breast cancer and parity characteristics; (d) PCM and ISC resemble invasive breast cancers and differ from normotypic mammary epithelium in regard to epithelial cell-lymphoreticuloendothelial relationships; (e) PCM and, particularly, ISC are associated with distinctive immunogenic components; (f) prognostically significant immunogens of invasive breast cancer tissues are related to and antigenically similar to immunogenic components of associated ISC; (g) immunogenic cancers (ISC and invasive) from different patients are antigenically similar to one another; (h) immunogenic cancers (ISC and invasive) from different patients are antigenically similar to some component of murine mammary tumor virus.

Our understanding and control of invasive breast cancer would be significantly advanced by additional knowledge regarding the development and characteristics of precursor lesions (PCM and ISC) and the ISC-invasive transition. ISC provides a uniquely valuable resource for studies of viral carcinogenesis and prognostically significant immunogenicity. The available data are consistent with the use of ISC-associated immunogens and/or antigenically similar components of murine mammary tumor virus to provoke prognostically favorable hypersensitivity responses, i.e., immunoprophylaxis. Such an experiment in immunoprophylaxis is supported by the unusually favorable stage and survival characteristics of breast cancers arising subsequent to the removal of precursor lesions.

¹ Presented at the Conference "Early Lesions and the Development of Epithelial Cancer," October 21 to 23, 1975, Bethesda, Md. These studies were supported in part by Contract NO1-CP-33398 within the Special Virus-Cancer Program, and Contract NO1-CP-33321 of the Field Studies and Statistics Program, National Cancer Institute, NIH, USPHS.