Aulmann S, Penzel R, Schirmacher P, Sinn H P
Pathologisches Institut, Universitäitsklinikum Heidelberg.
Verh Dtsch Ges Pathol. 2007;91:208-13.
Lobular carcinoma in situ (LCIS) of the breast typically is an incidental finding in breast biopsies performed for a variety of reasons. As patients with LCIS have a bilaterally increased risk of developing invasive ductal or lobular breast cancer, the lesion is presently considered an indicator rather than a direct precursor of breast cancer. However, this view is challenged by the finding that LCIS often accompanies invasive lobular carcinomas (ILC) and that the frequency of ILC following LCIS is far higher compared to unselected patients. To further examine the role of LCIS in the development of invasive breast cancer, we analysed a series of patients with pure LCIS, who later developed invasive breast cancer. Mitochondrial D-loop sequencing revealed a clonal relationship of LCIS and a subset of ILC occurring in the same breast between 2 and 10 years later. Apparently, LCIS has a chimeric role in breast cancer development and is not only a risk factor but in some cases a precursor of ILC.
乳腺小叶原位癌（LCIS）通常是在因各种原因进行的乳腺活检中偶然发现的。由于LCIS患者发生浸润性导管癌或小叶癌的双侧风险增加，目前该病变被视为一种指标，而非乳腺癌的直接前体。然而，这一观点受到以下发现的挑战：LCIS常伴随浸润性小叶癌（ILC），且与未经过筛选的患者相比，LCIS之后发生ILC的频率要高得多。为了进一步研究LCIS在浸润性乳腺癌发生中的作用，我们分析了一系列后来发生浸润性乳腺癌的纯LCIS患者。线粒体D环测序揭示了LCIS与2至10年后在同一乳腺中发生的一部分ILC之间的克隆关系。显然，LCIS在乳腺癌发生中具有嵌合作用，不仅是一个危险因素，而且在某些情况下是ILC的前体。
