title: Detection of human cytomegalovirus in normal and neoplastic breast epithelium.
abstract: BACKGROUND
  Human cytomegalovirus (HCMV) establishes a persistent life-long infection, and can cause severe pathology in the fetus and the immunocompromised host1. Breast milk is the primary route of transmission in humans worldwide, and breast epithelium is thus a likely site of persistent infection and/or reactivation, though this phenomenon has not previously been demonstrated. Increasing evidence indicates HCMV infection can modulate signaling pathways associated with oncogenesis. We hypothesized that persistent HCMV infection occurs in normal adult breast epithelium and that persistent viral expression might be associated with normal and neoplastic ductal epithelium.
  
  
  METHODS
  Surgical biopsy specimens of normal breast (n = 38) breast carcinoma (n = 39) and paired normal breast from breast cancer patients (n = 21) were obtained. Specimens were evaluated by immunohistochemistry, in situ hybridization, PCR and DNA sequencing for evidence of HCMV antigens and nucleic acids.
  
  
  RESULTS
  We detected HCMV expression specifically in glandular epithelium in 17/27 (63%) of normal adult breast cases evaluated. In contrast, HCMV expression was evident in the neoplastic epithelium of 31/32 (97%) patients with ductal carcinoma in situ (DCIS) and infiltrating ductal carcinoma (IDC) cases evaluated (p = 0.0009).
  
  
  CONCLUSIONS
  These findings are the first to demonstrate that persistent HCMV infection occurs in breast epithelium in a significant percentage of normal adult females. HCMV expression was also evident in neoplastic breast epithelium in a high percentage of normal and neoplastic breast tissues obtained from breast cancer patients, raising the possibility that viral infection may be involved in the neoplastic process.
authors.affiliation: Research Institute, California Pacific Medical Center, (475 Brannan St,, Suite 220) San Francisco CA, 94107, USA. charles.cobbs@gmail.com.
authors.forename: Lualhati E
authors.initials: LE
authors.lastname: Harkins
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Matlaf
authors.forename: Liliana
authors.initials: L
authors.lastname: Soroceanu
authors.forename: Katrin
authors.initials: K
authors.lastname: Klemm
authors.forename: William J
authors.initials: WJ
authors.lastname: Britt
authors.forename: Wenquan
authors.initials: W
authors.lastname: Wang
authors.forename: Kirby I
authors.initials: KI
authors.lastname: Bland
authors.forename: Charles S
authors.initials: CS
authors.lastname: Cobbs