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Presence of -Lactalbumin, Epidermal Growth Factor, Epithelial Membrane Antigen, and Gross Cystic Disease Fluid Protein (15,000 Daltons) in Breast Cyst Fluid¹

Radioimmunoassay Laboratory, Institute of Pathology, University of Liège, B-4000 Liège, Belgium

The frequency of gross cystic breast disease in premenopausal women and its possible association with increased breast cancer risk emphasize the importance of investigations relating to breast cyst fluid composition. In order to contribute to a better analysis of this medium, we have measured four proteins the presence of which in human milk was well documented.

Breast cyst fluid specimens from 266 breast cyst disease patients were assayed and compared as to concentrations of -lactalbumin, gross cystic disease fluid protein (GCDFP-15), epidermal growth factor (EGF), and epithelial membrane antigen (EMA).

All the analyzed cyst fluids contained GCDFP-15, EMA, and EGF whereas -lactalbumin was detected in only 14.2% of fluids assayed. Positive correlations were observed between GCDFP-15 and EMA concentrations (P < 0.005), as well as GCDFP-15 and EGF concentrations (P < 0.005). The cyst fluid GCDFP-15 and EGF levels were higher when -lactalbumin concentrations were below detection limits. This association was statistically significant for GCDFP-15 (P < 0.03) and for EGF (P < 0.001).

These results suggest that GCDFP-15 and EMA could be the biochemical expression of apocrine metaplasia and epithelial hyperplasia, respectively, two histopathological features which characterize breast cystic disease. On the other hand, the occasional presence of -lactalbumin in the cyst fluid would reflect the persistence of differentiated cells in the epithelium surrounding the cyst and would be inversely proportional to the degree of cellular proliferation.

The omnipresence of EGF in the cyst fluid argues for the hypothesis of its production by the mammary gland. The highly significant relationship between GCDFP-15 and EGF levels in the medium remains to be elucidated but may be related to an androgen sensitivity in the breast epithelium surrounding the cyst.

¹ Supported by Grant 3.4530.81 from the FRSM and by the Cancer Foundation of CGER.

² To whom requests for reprints should be addressed, at Institute of Pathology, University of Liège, C.H.U., Bat. B-23, B-4000 Sart-Tilman, Liège, Belgium.

Received 10/30/85. Revised 2/20/86. Accepted 3/25/86.