title: Vascular stroma formation in carcinoma in situ, invasive carcinoma, and metastatic carcinoma of the breast.
abstract: The generation of vascular stroma is essential for solid tumor growth and involves stimulatory and inhibiting factors as well as stromal components that regulate functions such as cellular adhesion, migration, and gene expression. In an effort to obtain a more integrated understanding of vascular stroma formation in breast carcinoma, we examined expression of the angiogenic factor vascular permeability factor (VPF)/vascular endothelial growth factor (VEGF); the VPF/VEGF receptors flt-1 and KDR; thrombospondin-1, which has been reported to inhibit angiogenesis; and the stromal components collagen type I, total fibronectin, ED-A+ fibronectin, versican, and decorin by mRNA in situ hybridization on frozen sections of 113 blocks of breast tissue from 68 patients including 28 sections of breast tissue without malignancy, 18 with in situ carcinomas, 56 with invasive carcinomas, and 8 with metastatic carcinomas. A characteristic expression profile emerged that was remarkably similar in invasive carcinoma, carcinoma in situ, and metastatic carcinoma, with the following characteristics: strong tumor cell expression of VPF/VEGF; strong endothelial cell expression of VPF/VEGF receptors; strong expression of thrombospondin-1 by stromal cells and occasionally by tumor cells; and strong stromal cell expression of collagen type I, total fibronectin, ED-A+ fibronectin, versican, and decorin. The formation of vascular stroma preceded invasion, raising the possibility that tumor cells invade not into normal breast stroma but rather into a richly vascular stroma that they have induced. Similarly, tumor cells at sites of metastasis appear to induce the vascular stroma in which they grow. We conclude that a distinct pattern of mRNA expression characterizes the generation of vascular stroma in breast cancer and that the formation of vascular stroma may play a role not only in growth of the primary tumor but also in invasion and metastasis.
authors.affiliation: Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
authors.forename: L F
authors.initials: LF
authors.lastname: Brown
authors.forename: A J
authors.initials: AJ
authors.lastname: Guidi
authors.forename: S J
authors.initials: SJ
authors.lastname: Schnitt
authors.forename: L
authors.initials: L
authors.lastname: Van De Water
authors.forename: M L
authors.initials: ML
authors.lastname: Iruela-Arispe
authors.forename: T K
authors.initials: TK
authors.lastname: Yeo
authors.forename: K
authors.initials: K
authors.lastname: Tognazzi
authors.forename: H F
authors.initials: HF
authors.lastname: Dvorak
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000098:blood supply / Q000737:chemistry / Q000473:pathology; D015415:Biomarkers; D001706:Biopsy; D001940:Breast / Q000098:blood supply / Q000737:chemistry; D001943:Breast Neoplasms / Q000098:blood supply* / Q000737:chemistry / Q000473:pathology; D002277:Carcinoma / Q000098:blood supply* / Q000737:chemistry / Q000473:pathology; D002278:Carcinoma in Situ / Q000098:blood supply* / Q000737:chemistry; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000737:chemistry / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000098:blood supply / Q000737:chemistry / Q000473:pathology; D018275:Carcinoma, Lobular / Q000098:blood supply / Q000737:chemistry / Q000473:pathology; D011508:Chondroitin Sulfate Proteoglycans / Q000032:analysis; D003094:Collagen / Q000032:analysis; D058575:Decorin; D016228:Endothelial Growth Factors / Q000032:analysis; D004730:Endothelium, Vascular / Q000737:chemistry; D004847:Epithelial Cells / Q000737:chemistry; D016326:Extracellular Matrix Proteins; D005260:Female; D005348:Fibrocystic Breast Disease / Q000378:metabolism / Q000473:pathology; D005353:Fibronectins / Q000032:analysis; D005629:Frozen Sections; D006801:Humans; D017403:In Situ Hybridization; D037181:Lectins, C-Type; D008207:Lymphatic Metastasis; D008222:Lymphokines / Q000032:analysis; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000032:analysis; D009389:Neovascularization, Pathologic; D020033:Protein Isoforms / Q000032:analysis; D011509:Proteoglycans / Q000032:analysis; D011518:Proto-Oncogene Proteins / Q000032:analysis; D012333:RNA, Messenger / Q000032:analysis; D012334:RNA, Neoplasm / Q000032:analysis; D020794:Receptor Protein-Tyrosine Kinases / Q000032:analysis; D017978:Receptors, Growth Factor / Q000032:analysis; D040262:Receptors, Vascular Endothelial Growth Factor; D017154:Stromal Cells / Q000473:pathology; D019700:Thrombospondin 1 / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A; D040281:Vascular Endothelial Growth Factor Receptor-1; D042442:Vascular Endothelial Growth Factors; D053675:Versicans
chemical_list: D015415:Biomarkers; D011508:Chondroitin Sulfate Proteoglycans; C546878:DCN protein, human; D058575:Decorin; D016228:Endothelial Growth Factors; D016326:Extracellular Matrix Proteins; D005353:Fibronectins; D037181:Lectins, C-Type; D008222:Lymphokines; D009363:Neoplasm Proteins; D020033:Protein Isoforms; D011509:Proteoglycans; D011518:Proto-Oncogene Proteins; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D017978:Receptors, Growth Factor; D019700:Thrombospondin 1; C508322:VCAN protein, human; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D053675:Versicans; D003094:Collagen; D020794:Receptor Protein-Tyrosine Kinases; D040262:Receptors, Vascular Endothelial Growth Factor; D040281:Vascular Endothelial Growth Factor Receptor-1