Klinger Francesco, Vinci Valeriano, Lozito Alessia, Agnelli Benedetta, Lisa Andrea, Battistini Andrea, Bonovas Stefanos, Piovani Daniele, Klinger Marco, Di Tommaso Luca
Department of Health Sciences, Ospedale San Paolo, University of Milan, Via Antonio di Rudinì, 8, 20142, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele - Milan, Italy.
Aesthetic Plast Surg. 2023 Apr;47(2):605-611. doi: 10.1007/s00266-022-03127-8. Epub 2022 Oct 6.
Tuberous breast deformity (TB) is a condition mostly characterized by breast stenosis, areolar widening and glandular asymmetry. The most accredited hypothesis describes an abnormal thickening of the fascia corporis that might influence an alteration in the glandular development, limiting the horizontal growth of breast parenchyma. Alterations in the extracellular matrix components (ECM) might be involved in the abnormal breast development.
The aim of our case control study is to use histological specimens to analyze qualitative and quantitative differences in collagen fibers, elastic fibers and vessel densities in TB and normal breasts of 20 patients using a software for digital pathology.
The quantitative findings showed increasing concentrations of collagen fibers and decreasing elastic fibers in TB, compared to normal breasts. No difference was seen in vessel density among the two groups. The qualitative findings highlighted differences in the distribution of the ECM among the TB specimens. Collagen fibers showed a packed appearance rather a scattered distribution, while elastic fibers visibly presented a reduction and a focal distribution of their concentration.
The study proposes a correlation between abnormalities in ECM concentrations and TB, resulting in a higher degree of fibrosis and in the characteristic stenotic and less elastic morphology of the deformity.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
管状乳房畸形（TB）的主要特征是乳房狭窄、乳晕增宽和腺体不对称。最被认可的假说是描述了体筋膜的异常增厚，这可能会影响腺体发育的改变，限制乳腺实质的水平生长。细胞外基质成分（ECM）的改变可能与乳房异常发育有关。
我们病例对照研究的目的是使用组织学标本，通过数字病理学软件分析20例患者的TB乳房和正常乳房中胶原纤维、弹性纤维和血管密度的定性和定量差异。
定量结果显示，与正常乳房相比，TB乳房中胶原纤维浓度增加，弹性纤维减少。两组之间的血管密度没有差异。定性结果突出了TB标本中ECM分布的差异。胶原纤维呈现密集外观而非散在分布，而弹性纤维明显呈现浓度降低和局灶性分布。
该研究提出ECM浓度异常与TB之间存在相关性，导致更高程度的纤维化以及畸形特有的狭窄和弹性较小的形态。
证据等级IV：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
