VOL. 4, No. 1, January 2008

L. M. Agius [2008] Med. Hypotheses Res. 4: 21‒27.

Pathophysiology of Breast Carcinogenesis as Stromal-
Epithelial Cell Interactivity

Lawrence M. Agius*

Department of Pathology, St Luke’s Hospital, Gwardamangia, University of Malta Medical
School, Msida Malta, Europe

Abstract. Evolving consequences of a series of genotoxic events reproducibly enhance
the interactivity between stromal cells and the epithelial cells of the terminal ductule-lobular
units of the breast. Realized involvement of angiogenic and apoptotic responses would
characterize activation of the damaged DNA microenvironment as related particularly to
stromal cell elements. Involvement of variability of response of epithelial cells and the
ongoing development of the genotoxic pathways as evidenced by oxidative stress and
apoptosis/necrosis of epithelial cells implicate a successive series of events that further
compromise recoverability of normal processing pathways within damaged cells. One might
speak of a complex interplay of apoptosis and anti-apoptosis pathways in the reconstruction
of a patch architecture reflected secondarily in models of clonality and polyclonality that go
beyond simple characterization of monoclonal derivation from a single common cell of
origin of the breast neoplasm.

* Correspondence: Dr. Lawrence M. Agius, Department Of Pathology, St Luke’s
Hospital, Gwardamangia, University Of Malta Medical School, Msida Malta, Europe. Tel:
356-21451752. Fax: 356-2595-6317.

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