ARTICLE |
Correspondence to: Henry J. Thompson, AMC Cancer Research Center, 1600 Pierce Street, Denver, CO 80214. E-mail: thompsonh@amc.org
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Summary |
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Studies of the vascularization of autochthonous rodent mammary tumors are limited in number, and the majority have used Factor VIII staining for blood vessel detection. Moreover, little effort has been directed at measuring the vascularization of tissue immediately adjacent to a tumor despite its central importance in the process of angiogenesis. Thirty-six chemically-induced mammary carcinomas and tissue immediately adjacent to these carcinomas were used to develop a census counting method for quantitative assessment of intra- and extra-tumor vascularization. Blood vessels were identified using antiserum directed against either CD31 or Factor VIII. Techniques used to create digitized images of all tumors and the semi-automated methods for circumscribing the extra-tumoral region are described. For Factor VIII, CD31 allowed greater discrimination of blood vessels with areas <25 µm2 and demonstrated crisp staining of blood vessels, with minimal background and excellent preservation of tissue architecture. Census counting data support the use of CD31 for quantifying both intra- and extra-tumoral vascularization. This method provides a basis for standardizing the approach to evaluation of experimentally induced premalignant and malignant mammary lesions in rodent model systems used to investigate potential anti-angiogenic cancer preventive agents. (J Histochem Cytochem 50:213222, 2002)
Key Words: angiogenesis, CD31, Factor VIII, image analysis, mammary cancer
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Introduction |
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IN VIVO, the supply of blood to newly forming tissues and to tumors is a limiting factor that regulates growth (
The work reported here was initiated (a) to develop a method suitable for profiling the vascularization of mammary tumors and the extra-tumoral region of the mammary gland immediately adjacent to a tumor and (b) to determine empirically whether CD31 would yield better staining than Factor VIII in rodent mammary tissue and tumors. No attempt was made to constrain method development based on concerns about direct clinical applicability, particularly as it relates to the amount of time required for the assay to be performed, because the method was intended for use in the research setting. A semi-automated process is described for use in defining a 50-µm perimeter around tumor areas and for utilizing image analysis systems to quantitatively evaluate vascularization of rat mammary carcinomas.
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Materials and Methods |
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Chemicals and Reagents
The carcinogen MNU was obtained from Ash Stevens (Detroit, MI). Pepsin (Fisher Scientific; Pittsburgh, PA) enzyme digestion was performed on sections for the detection of Factor VIII. Donkey serum (Jackson ImmunoResearch; West Grove, PA) was used as blocking serum to prevent nonspecific binding of primary antibodies. Rabbit anti-Von Willebrand Factor (Factor VIII) antibody was obtained from Dako (Carpinteria, CA) and goat anti-CD31 (PECAM1) antibody from Research Diagnostics (Flanders, NJ). Biotinylated secondary antibodies, donkey anti-rabbit F(ab')2 (Jackson ImmunoResearch) and donkey anti-goat IgG (Jackson ImmunoResearch) were applied for Factor VIII and CD31, respectively. Horseradish peroxidase-conjugated streptavidin (Dako) and Stable DAB (Research Genetics; Huntsville, AL) were used in the visualization of blood vessels.
Animal Protocol and Necropsy Procedures
Twenty-day-old female SpragueDawley rats were obtained from Taconic Farms (Germantown, NY). Animals were housed three per cage in polycarbonate solid-bottomed cages in an environmentally controlled room maintained at 22C and 50% relative humidity with a 12 hr light/dark cycle. All rats were maintained on a purified diet, AIN 93G, formulated as described by our laboratory (
Specimen Selection
All lesions evaluated were mammary gland carcinomas of cribriform, papillary, comedo, or mixed histological types. Serial paraffin sections of each formalin-fixed carcinoma were cut at 4 µm and mounted on 3-aminopropyltriethoxysilane (APES)-treated slides. Sections were heat-immobilized in an 80C oven for 20 min, deparaffinized in three changes of xylene, hydrated in a series of graded ethanols, and rinsed in several changes of deionized water (DW). Carmine stain was removed by immersing sections in 0.1% lithium carbonate for 5 min, followed by several changes of DW.
Pretreatment
Enzymatic digestion was performed on sections designated for Factor VIII only. Sections were incubated using a modified version of the pepsin digestion protocol established by
Immunohistochemistry
Endogenous peroxidase activity was quenched by immersing sections in 3% H2O2 for 5 min. Sections were rinsed in several changes of DW followed by PBS, pH 7.4, three times for 5 min. All subsequent steps were performed in a humidity chamber at RT. Donkey serum, 1:5, was applied to all sections for 20 min. Excess serum was drained and primary antibody, rabbit anti-Factor VIII (1:800) or goat anti-CD31 (1:75), was applied to positive sections and incubated for 30 min or 1 hr, respectively. Negative control sections were held in PBS during the primary incubation. Sections were rinsed in PBS three times for 5 min. Biotinylated secondary antibodies, donkey anti-rabbit F(ab')2 (1:1000) or biotinylated donkey anti-goat IgG (1:500) were applied to all sections and incubated for 30 min. Sections were rinsed in PBS three times for 5 min. The enzyme label, horseradish peroxidase-conjugated streptavidin (1:1000) was applied to all sections and incubated for 30 min. Sections were rinsed in PBS three times for 5 min. Stable DAB was applied to all sections and incubated for 6 min. Sections were rinsed in several changes of DW and counterstained as previously described (
Image Acquisition
Images of immunostained sections were captured with a Kodak DCS-420 digital camera (Eastman Kodak; Rochester, NY) mounted on a Zeiss Axioskop microscope (Carl Zeiss; Thornwood, NY) using a x10 objective. The CCD imaging sensor on the DCS-420 has a focal magnification of x2.5, yielding images with an approximate total magnification of x250. The resolution of each image was 1012 x 1524 or 1.5 megapixels. Images were acquired using a 32-bit Kodak TWAIN driver v5.02 within Adobe Photoshop v4.0 graphic software (Adobe Systems; San Jose, CA) running on a 300 MHZ Pentium III PC with 128 MB of RAM. Tumors that exceeded the size of a single imaging area were captured by photographing contiguous microscopic fields in a raster pattern. Each captured image was merged using the layer technique in Adobe Photoshop to form a single composite image for analysis.
Spatial Calibration
CD31 and Factor VIII IHC stains were evaluated using Image Pro Plus (IPP) v4.1 (Media Cybernetics; Silver Spring, MD). Spatial calibration was determined by photographing a 1-mm stage micrometer using the same parameters as those for image capture of immunostains. The distance drawn on the 1-mm calibration image was divided by 1000 to find the number of pixels per micrometers, which equaled 1.12 pixels.
Area Measurement
Epithelial areas within each tumor were circumscribed using the irregular area of interest (AOI) tool in IPP (Fig 1A) in combination with an Intuos digitizing pen and tablet (Wacom Technology; Vancouver, WA). A macro was then used to construct a 50-µm boundary using the AOIs. The macro loaded the spatial calibration and the intensities for all three-color channels, red, green, and blue, were set to maximal range (0255). The areas of the AOIs were measured using the count feature under the count/size menu (Fig 1B). The sum area of the AOIs in µm2 was written to an Excel spreadsheet as intra-tumoral area (IA) via dynamic data exchange (DDE). An image mask was created, resulting in a binarized image of white AOIs with pixel values of 255 on a black background with pixel values of zero (Fig 1C). The mask was inverted, resulting in black AOIs on a white background (Fig 1D). A Euclidian distance map image filter was applied to the inverted mask (Fig 1E). The value of each pixel outside each AOI is the shortest distance from that pixel to the edge of the AOI. All pixels along the AOI border have a pixel value of 1 because they are 1 pixel away from the AOI. Pixels that are 2 pixels from the border have a value of 2, and so on. Using the number of pixels per micrometer measurement from the spatial calibration, it was determined that a 50-µm distance would be equal to 56 pixels. Therefore, the intensity range on the distance map image was set to 0 and 56 (Fig 1F). A mask was created, resulting in white AOIs plus a white 50-µm border around each AOI on a black background (Fig 1G). The white area was counted using the "automatic bright objects" feature under the count/size menu in IPP. The sum of the white area in µm2 was written to an Excel spreadsheet as total area (TA) via DDE. An outline of the white area was saved to a file and then superimposed on the original image using the "load outlines" feature (Fig 1H). Extra-tumoral area (EA) was calculated by subtracting IA from TA.
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Blood Vessel Identification
Tumor architecture presented a challenge in determination of extra-tumoral and intra-tumoral vessels (Fig 2A). All vessels were circumscribed manually, using the digitizing pen, to rule out inclusion of artifact or background immunostaining. Criteria established by
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Extra-tumoral vessels were measured first for all tumors. Extra-tumoral vessels (yellow) were defined as vessels existing outside the IA and lying within or in direct contact with the 50-µm border (red) surrounding the tumor (Fig 2B2D). Intratumoral vessels (magenta) were defined as vessels within the epithelial portions of the tumor (Fig 2) or areas within opposing AOI boundaries (green) (Fig 2). Measurements for all vessels were recorded in µm2 and exported to an Excel spreadsheet via DDE. All data were exported to Systat v9.01 (SPSS; Chicago, IL) for statistical analysis. The specific statistical tests used are described in the table and figure legends.
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Results |
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Qualitative Assessment
Blood vessels were detected immunohistochemically from serial sections of 36 mammary carcinomas with the use of CD31 and Factor VIII antibodies. Images were captured according the procedures outlined in Materials and Methods. As shown in Fig 2, IHC staining protocols provided specific staining of blood vessels with limited background staining. However, background staining was somewhat higher in Factor VIII-stained sections. The procedure used for Factor VIII involved digestion of the tissue with pepsin, which caused tissue detachment and altered morphology, particularly noticeable intra-tumorally (Fig 3A). Conversely, the CD31 protocol used HIER for epitope retrieval, resulting in crisp vessel staining with only minor tissue detachment while maintaining morphological integrity (Fig 3B).
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Vascular Area
All carcinomas were census-counted, i.e., the entire four micron section of the carcinoma was evaluated for intra-tumoral blood vessels. In addition, a 50-µm-wide band that circumscribed all elements of each carcinoma (referred to as extra-tumoral blood vessels, shown in Fig 2) was assessed. Area measurement for each blood vessel was recorded in addition to location, i.e., intra- or extra-tumoral. Table 1 shows the total area (tumor area plus 50-µm boundary around tumor) and the total vascular area that were assessed using each detection antiserum. The distribution of these areas by location of the blood vessel (intra- or extra-tumoral) is also presented. Overall, essentially identical total areas were assessed for vessels using CD31 or Factor VIII (areas differed by only 0.6%). Similarly, the total vascular area identified using CD31 or Factor VIII differed by only 4.4%. However, striking differences were noted when the distribution of vascular areas was categorized according to vessel location. Overall, vascular area constituted approximately 2.0% of the total area assessed. However, this indicator of the degree of vascularity was markedly different by region. The percent of total area that was composed of blood vessels was approximately 6.0% in the extra-tumoral region, whereas it was only 0.7% intra-tumorally. While similar total intra- and extra-tumoral areas were assessed for blood vessels detected by either CD31 or Factor VIII (differing only by 6.3 and 3.2%, respectively), the total vascular area identified by CD31 and Factor VIII differed by region. Total extra-tumoral vascular area was 13.9% higher with CD31 than with Factor VIII (6.2% and 5.18%, respectively), whereas total intra-tumoral vascular area was 45.9% higher with Factor VIII vs CD31 (0.48% and 0.91% for CD31 and Factor VIII, respectively). One likely reason for this difference is illustrated in Fig 3. As noted above, either detection antiserum resulted in specific vessel staining with limited background staining. However, as shown in Fig 3C3D, background staining was higher with Factor VIII than with CD31. This background staining, in combination with the distortion of tissue morphology observed in Factor VIII-stained sections, made vessel detection and image analysis more error prone with Factor VIII, whereas with CD31 the stain was crisp, with well-defined outlines of blood vessels. Absence of background staining facilitated the identification of individual small blood vessels in the CD31-stained section (Fig 3D), whereas the small vessels were more difficult to distinguish in the Factor VIII-stained serial sections (Fig 3C). This resulted in an under-estimation of the number of small blood vessels that were present because they were recorded as a single larger vessel. It is noteworthy that this problem was primarily encountered with the intra-tumoral blood vessels and is probably due to the nature of tissue processing required for retrieval of tissue and tumors from carmine-stained mammary gland whole-mount preparations. Therefore, this particular observation may be specific to the processing used in evaluating tissue from mammary gland whole mounts in this model system.
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Vascular Evaluation
A total of 12,138 blood vessels were detected in the analysis of CD31-stained carcinomas; a similar number, 11,732 was detected in the Factor VIII-stained sections (Table 2). The smallest blood vessel detected by either stain was 2.4 µm2. The largest vessel detected using CD31 was 0.08 mm2, whereas the largest vessel detected using Factor VIII was 0.12 mm2. Overall, approximately twice as many vessels were detected in the extra-tumoral vs intra-tumoral region, irrespective of the type of antiserum used to detect the vessels. These findings led to the analysis of average vessel size. Both the mean and the median average vessel area was higher with Factor VIII than with CD31 (p<0.05). Moreover, the median vessel areas were considerably lower than mean values, indicating that the distribution of vessel sizes was asymmetrical. This observation was confirmed statistically via the measurement of the skewness and kurtosis of each distribution. Those analyses indicated a long right-handed tail to the distribution of blood vessel sizes (vessel area) and that the tail of the distribution was greater than for a normal distribution. The graphical analysis of the data shown in Fig 4A and Fig 4B confirmed this observation. As shown in Fig 4C and Fig 4D, logarithmic transformation of the blood vessel area data normalized the distribution; consequently, the log transformed data were used for all statistical analyses as recommended in
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Range of Vessel Sizes
To pursue the observation that CD31 appeared to detect more smaller blood vessels, a stem-leaf plot analysis was performed on all data, irrespective of vessel location or detection system. This provided information on the distribution of vessel area by quartiles. Twenty-five percent of all vessels detected were <25µm2. Interestingly, the diameter associated with this area is 5.6 µm, slightly larger than the average diameter of a formalin-fixed, paraffin-embedded red blood cell in rats, which was determined to be 5.5 µm by image analysis (data not shown). The next 25% of vessels had an area that was 25 and
56 µm2. The third quartile of vessel sizes was >56 and
147 µm2. The fourth quartile included vessels with an area >147 µm2. The numbers of blood vessels falling into each of these size ranges, as categorized by location and detection antiserum, are shown in Table 3. CD31 detected approximately twice as many vessels that were <25 µm2 as were detected by Factor VIII. More of these small vessels were detected by CD31 in the extra- vs the intra-tumoral region. The numbers of vessels detected using either CD31 or Factor VIII and whose area ranged from
25 and
56 µm2 were similar. For the remaining vessel area categories, more vessels were detected by Factor VIII than by CD31.
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Discussion |
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The goal of the work reported here was to develop a method suitable for quantifying the vascularization of carcinomas arising in the mammary gland and that would permit the investigator to retain knowledge of the anatomic location of the tumor and its proximity to other mammary gland pathologies and/or anatomic structures within the gland. For this reason, mammary carcinomas were induced using a model system from which mammary gland whole mounts can be prepared and the areas of interest visualized and dissected (
At the outset of this study, a review of the literature indicated that antiserum directed against Factor VIII was selected in most work in which immunostaining was being used to detect blood vessels in mammary tissue (25 µm2, no consistent statistically significant advantage was attributable to the use of either antiserum. We attribute the tendency for Factor VIII to detect larger vessels to a misclassification error due to a tissue processing artifact that occurred with Factor VIII staining. Epitope retrieval for Factor VIII staining included the treatment of tissue sections with pepsin. This process caused areas of a tissue section, particularly tumor epithelial cells, to detach from the slide, resulting in loss of the cells from the section and a decrease in the architectural integrity of the section (Fig 3A3D). This problem was not encountered using the HIER method with CD31. Although this artifact of sample processing is likely to be limited to tissue excised from carmine-stained mammary gland whole mounts, it is noteworthy because it appeared to decrease the ability to detect small blood vessels (<25 µm2) within tumors and resulted in an increase in the vascular area ascribed to larger blood vessels. Given the greater sensitivity to detect vessels of all sizes in the absence of processing artifacts, the use of CD31 immunostaining is recommended for blood vessel quantification in rat mammary tissue.
Census-counting of blood vessels was used in this work and this approach enabled us to determine the frequency with which blood vessels of different sizes occurred. The results, shown in Fig 4, are consistent with circulatory physiology, in that the number of blood vessels of a particular size decreased as the size of the vessels increased. This fact is not likely to be fully appreciated by many scientists studying quantitative aspects of vascularity. However, it has a number of important implications. First, irrespective of the range of blood vessel sizes selected for investigation, the distribution of the vessels counted will be asymmetric, with an extended right-handed tail. Such data violate one of the assumptions underlying most parametric statistical procedures, i.e., that the data are normally distributed. As shown in Fig 4C and Fig 4D, logarithmic transformation of the vessel area data normalized the distribution, making it suitable for parametric statistical analyses such as ANOVA. Log transformation of vessel area data is recommended instead of the use of non-parametric rank tests, which do not fully take into account the magnitude of differences that may exist between two different populations of blood vessels. This issue applies not only to census-counted data sets, such as the one reported in this study, but also to data sets in which vessel density data are obtained by the hot-spot, Chalkley, or random-field methods of data acquisition (
A final observation emerging from this work relates to the assessment of vascularity in the 50-µm band circumscribing the tumor (extra-tumoral). In previous studies of premalignant breast disease, various approaches to the evaluation of blood vessels in the stroma surrounding a lesion have been reported (reviewed in
In conclusion, maximal information can be derived concerning the vascularization of mammary tissue and tumors within the mammary gland if specimens are harvested from mammary gland whole-mount preparations. CD31 immunostaining was found to be superior to Factor VIII in detecting vessels of all sizes because of minimal background staining and the elimination of processing artifacts observed in Factor VIII-immunostained preparations. Census-counting of blood vessels provides the greatest amount of information and revealed an asymmetric distribution of blood vessel sizes that must be taken into account both in the statistical analyses of data and in selection of histological fields for counting if census-counting is not performed. In characterizing the vascularization of premalignant mammary lesions, consideration should be given to evaluating the extra-tumoral pattern of vessel occurrence by census-counting using the semi-automated methods described.
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Acknowledgments |
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Supported by PHS grant CA 52626 from the National Cancer Institute.
Received for publication June 11, 2001; accepted October 3, 2001.
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Literature Cited |
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![]() ![]() ![]() ![]() ![]() ![]() ![]() |
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BurfordMason AP, MacKay AJ, Cummins M, Dardick I (1994) Detection of proliferating cell nuclear antigen in paraffin-embedded specimens is dependent on preembedding tissue handling and fixation. Arch Pathol Lab Med 118:1007-1013[Medline]
Djonov V, Andres AC, Ziemiecki A (2001) Vascular remodelling during the normal and malignant life cycle of the mammary gland. Microsc Res Tech 52:182-189[Medline]
Folkman J (1971) Tumor angiogenesis: therapeutic implications. N Engl J Med 285:1182-1186[Medline]
Folkman J, D'Amore PA (1996) Blood vessel formation: what is the molecular basis? Cell 87:1153-1155[Medline]
Folkman J, Watson K, Ingber D, Hanahan D (1989) Induction of angiogenesis during the transition from hyperplasia to neoplasia. Nature 339:58-61[Medline]
Fregene TA, Khanuja PS, Noto AC, Gehani SK, Van Egmont EM, Luz DA, Pienta KJ (1993) Tumor-associated angiogenesis in prostate cancer. Anticancer Res 13:2377-2381[Medline]
Guidi AJ, Fischer L, Harris JR, Schnitt SJ (1994) Microvessel density and distribution in ductal carcinoma in situ of the breast. J Natl Cancer Inst 86:614-619[Abstract]
Guinebretiere JM, Le Monique G, Gavoille A, Bahi J, Contesso G (1994) Angiogenesis and risk of breast cancer in women with fibrocystic disease. J Natl Cancer Inst 86:635-636. [Letter; Comment][Medline]
Hayashi Y, Koike M, Matsutani M, Hoshino T (1988) Effects of fixation and enzymatic digestion on immunohistochemical demonstration of bromodeoxyuridine in formalin-fixed, paraffin-embedded tissue. J Histochem Cytochem 36:511-514[Abstract]
Heffelfinger SC, Gear RB, Taylor K, Miller MA, Schneider J, LaDow K, Warshawsky D (2000) DMBA-induced mammary pathologies are angiogenic in vivo and in vitro. Lab Invest 80:485-492[Medline]
Heffelfinger SC, Yassin R, Miller MA, Lower E (1996) Vascularity of proliferative breast disease and carcinoma in situ correlates with histological features. Clin Cancer Res 2:1873-1878[Abstract]
James JD, HauerJensen M (1999) Effects of fixative and fixation time for quantitative computerized image analysis of immunohistochemical staining. Histotechnology 22:109-111
Kaidoh T, Yasugi T, Uehara Y (1991) The microvasculature of the 7,12-dimethylbenz(a)anthracene (DMBA)-induced rat mammary tumour. I. Vascular patterns as visualized by scanning electron microscopy of corrosion casts. Virchows Arch 418:111-117. [A]
McGinley JN, Knott KK, Thompson HJ (2000) Effect of fixation and epitope retrieval on BrdU indices in mammary carcinomas. J Histochem Cytochem 48:355-362
Ottinetti A, Sapino A (1988) Morphometric evaluation of microvessels surrounding hyperplastic and neoplastic mammary lesions. Breast Cancer Res Treat 11:241-248[Medline]
Pepper MS, Baetens D, Mandriota SJ, Di Sanza C, Oikemus S, Lane TF, Soriano JV, Montesano R, IruelaArispe ML (2000) Regulation of VEGF and VEGF receptor expression in the rodent mammary gland during pregnancy, lactation, and involution. Dev Dyn 218:507-524[Medline]
Snedecor GW, Cochran WG (1967) Statistical Methods. 6th ed Iowa State University Press, 1, pp. 35148
Thompson HJ, McGinley JN, Rothhammer K, Singh M (1995) Rapid induction of mammary intraductal proliferations, ductal carcinoma in situ and carcinomas by the injection of sexually immature female rats with 1-methyl-1-nitrosourea. Carcinogenesis 16:2407-2411[Abstract]
Vermeulen PB, Gasparini G, Fox SB, Toi M, Martin L, McCulloch P, Pezzella F, Viale G, Weidner N, Harris AL, Dirix LY (1996) Quantification of angiogenesis in solid human tumours: an international consensus on the methodology and criteria of evaluation. Eur J Cancer 32A:2474-2484[Medline]
Weidner N, Semple JP, Welch WR, Folkman J (1991) Tumor angiogenesis and metastasiscorrelation in invasive breast carcinoma. N Engl J Med 324:1-8[Abstract]
Zhu Z, Haegele AD, Thompson HJ (1997) Effect of caloric restriction on premalignant and malignant stages of mammary carcinogenesis. Carcinogenesis 18:1007-1012[Abstract]