In other cases no significant deflection of potential 
was found in relation to the surronding lung tissue. It 
is now apparent that electric potentials of mammary 
neoplasms in relation to their surrounding normal tis­
sue are similar to those of pulmonary tumours. The same types of M-and W ·shaped profiles of pOtential 
have been encountered in breast as in lung. Different tissues grow at different rates. A differ­
ence of electric pOtential should then arise as a "devel­
opmental potential" for abnormal tissue in relation to 
the "functional demand pOtential" of the surrounding 
normal tissue. If this reasoning is correct, then one 
might expect thar a rapidly growing tumour should 
present a correspOndingly large pOtential difference in 
relation to its surroundings. No such correlation bas 
yet been observed . On the contrary, at least in the 
lung, any histologic or cytologic type of tumour may 
pOSsess an electropOsitive, electronegative or zero pa· 
tential. Potential measurements therefore can not be 
used for differential diagnosis. This finding has led to 
the bypatbesis that a common denominator explaining 
the varying palarity and amplitude of tumour pOten­
tials in relation to surrounding tissue may be the de­
generative phenomena often encountered in rumours. A degr•ding process such as SpOntaneous necrosis or 
bleeding in lung tumours was earlier proposed to pro­
duce a nonspecific physicochemica l pOtential of tissue 
injury. The degrading of tissue in this view represents 
a dynamic process. Depending on the phase of the 
Fig. XVI: /0. Electropositive potential in a poorly differenti­
oted ductal breast carcinoma (55-year.old woman). (o) Mam­
mogram. The tumour is surrounded by an irregularly radio­
lucent "A" zone (dark halo) which in turn is surrounded by 
a radiodense "8" zone(white halo). No calcifications, rndiat· 
ing structures or circularly displaced structures arc seen in 
this case. (b) Tracing of potential through the tumour, which 
had a relatively electropositive centre. Ecg is superimpose d 
on tracing. Grounded reference electrode in the subcutis of 
the shoulder. b 
[smv 
11-8U586 Nonlntstrilm degradation, electric palarization may be either pOSi­
tive or negative. Regardless of palarity, BCEC chan· 
nels will aid in levelling of the pOtential difference. We 
do not know how intensely the pOtential difference is 
being generated or how efficiently the levelling of the 
potential gradient takes place. The magnitude of mea­
sured pOtential difference is therefore of little impar­
rance. We CAn only conclude that potential differences 
can be recognized between tissue regions, a prerequi­
site for electrogenic transpOrt of material between the 
two tissue regions. The total amount of transparted 
material does depend, however, on the factor of time. TranspOrt S of considerable amounts of material are 
therefore passible at relatively low gradients if the 
transparts take place over long periods of time. Three of the breast carcinomas (Figs. XVI: 8, 9, 10) 
showed pasitive pOtentials in relation to the grounded 
subcutaneous electrode. Two of these cancers also 
contained calcium depasits, which makes it likely that 
they (at least for some time) contained regions which 
were relatively electronegative, th.ereby attracting ca­
tions such as calcium ovrr a closed electric circuit. Next we will study the morphologic appearance s of 
altered tissue around and inside breast tumours. These 
alterations will then be compared with the appearances 
and biokinetic background of similar structures 
around pulmonary carcinomas. Finally we will show 
also that many of the structural changes in the breast, 
like those in the lung, can be produced by experimen· 
tal palarization of tissues over closed electric circuits. B. Radiating structures 
Infiltrating duct cell carcinomas accompanied by fi. brosis represent the most common type of breast can­
cer. The fibrosis commonly appears in a stellate radia­
ting pattern about these tumours. Although these so­
called scirrhous carcinomas represent 70 per cent of all 
mammary carcinomas (55), variably pronounced peri­
focal fibrosis is also seen around other rypes of breast 
carcinomas , i.e., around medullary and lobular carci­
nomas. On the other band, any kind of breast cancer, 
including infiltrating duct cell carcinoma, may appear 
without fibrosis. Fibrosis in breast, moreover, is also observed 
around nodular mammary tuberculosis (65). Scleros· 
ing adenosis, fibroadenomas , chronic mastitis and 
healed fat necrosis are Qthcr bc-n.ign conditions pre­
senting "productive" fibrosis (55). Fibrosis around mammary carcinomas is, therefore, 
a common but nonspecific feature of the disease. The 
validity of the term "scirrhous carcinoma " as a charac· 
teristic feature of a specific type of carcinoma is there­
fore questionable. BCEC in cancer of the breast 211 The literature on breast cancer caJls radiating struc· 
tures by many names: spicules, cicatricial changes, 
sunburst changes, stellate strands, productive fibrosis, 
scirrhous changes, spiculae, spiculations, perifocal 
striate fibrosis, striae, productive fibrosis or hyalino­
sis, long radiating fibrous tentacles, "Krebsfiisse" , 
dendritic margins and shaggy margins. Histochemically, radiating structures are character ­
ized by fibrotic material containing elastin, collagen 
and hyaline components (7, 20, 49). Near the tumour 
the radiating structures may contain blood vessels, 
extravascular white blood corpuscles and also carcino­
matous cells, often arranged in rows. Sometimes can­
cer cells are found isolated, forming discontinuous 
streaks or islands within the fibrotic tissue. Distant 
from the tumour the peripheral parts of radiating 
Structures usually contain only fibrotic material with­
out other cell or tissue components. For simplicity and 
accuracy of description, then, the nonspecific term 
radiating structures is here introduced as a term suitable 
for radiographic descriptions. Radiating structures are believed by some examiners 
to represent a reaction of tissue in the surroundings of 
a tumour and arc therefore not to be regarded as 
produced directly by tumour growth (20, 55, 68). The 
opinion has also been put forward that radiating scar 
tissue (and adenosis) is involved as a primary factor in 
the growth of breast cancer (6, 12, 34, 48, 67, 86) but 
this has been doubted by McDivitt, et a!. (27), Haa­
gcnsen (47), Fenoglio and Lanes (33), Tremblay (90) 
and Azzopardi (9). An antigen-antibody reaction is also considered to 
take place around tumours ( 15, 25), leading to the 
formation of fibrin and hyaline as well as an amyloid­
like substance (89). Radiating structures do not develop from the tu· 
mour itself, according to von Albertini (3), but more 
212 BCEC in cancer of the breast Fig. XVI: II. Variable 
straightness of radiating 
structures. Mammograms 
of ductal breast carcinoma 
(66-year-old woman). Thin radiating structures 
extend several em into the 
tissue: surrounding the ru­
mour. The curved shapes 
of some of these structures 
appear '"relaxed''. likely arise from the surrounding tissue. Gullino and 
Grantham (46), Underwood (91), Douglas and Sbivas 
(28), on the other hand, all consider the fibrotic reac­
tion to be an expression of the biologic characteristics 
of the tumour tissue. The radiating structures around mammary carcino­
mas also contain a considerable amount of elastic tis· 
sue, compared with normal breast (28). In an excellent monograph on mammography, 
Hoeffken and Lanyi (55) state: "The stellate fibrous 
extensions are called cancer feet. This is not actual 
tumor tissue but rather a fibrotic reaction of adjoining 
breast !.issue to the carcinoma . With extensive spread, 
however, even these fibrotic hyalinized bonds of con­
nective tissue may be invaded by tumor cells. So far 
there is no satisfactory explanation why such a desmo· 
plastic response is elicited by scirrhous carcinoma or 
what may be the histochemical or immunologic cause 
for this response." The topography of the radiating structures around 
mammary carcinomas is of considerable interest. The 
structures are usually arranged in approximately 
straight lines perpendicular to the tumour surface. They may proceed far out into the surrounding breast 
tissue regardless of its basic structural arrangement . In 
this respect the radiating strucrures around certain 
breast tumours behave the same as the radiating struc­
tures around certain lung lesions. Tbin radiating structures of variable straighmess in 
two examples (Figs. XVI: II, 12) can be seen extend­
ing several em into the tissue around a breast carcino­
ma. The radiating structures in Fig. XVI: II are not 
quite straight and therefore appear "relaxed". In other 
cases the radiating structures appear straight, as if they 
were contracted. The carcinoma in Fig. XVI: 12 shows 
an abundance of radiating structures which are moder· 
ately straight. Peripherally they are thin. Close to the Fit. XVI: 12. Variable thickness or ~diatina struetures . Mammosram or a breast carcinoma (68-year-old woman). Many radiatina structures are mod~tel y straight. Some, 
however, look as if they retra<:t the nipple and adjacent 
"thickened" skin. They are thicker at the tumour than in 
their periphe~l parts. tumour they are broad. Some of them appear to be 
retracting a locally "thickened" pan of the skin. Discussion 
Radiating structures around mammary and pulmonary 
lesions appear similar. They develop more or less per­
pendicular to the surface of the lesions, regardless of 
the topography of the underlying normal structures. The presence of positive or negative polarization in 
relation to the tissue surrounding a breast tumour 
should, as in the lung, be able to produce radiating 
structures over the proposed biologically closed elec­
tric circuits. Electrophoretic and electroosmotic trans­
ports over a BCEC should build up the radiating 
structures from different available interstitial ions, 
nonorganized cells, debris and macromolecules, all or 
which then should be oriented under the innucnce of 
the electric field. ln this connection it should be point­
ed out that ionic material will not be the only material 
to move in the field. Nonpolar molecules which are 
not organized may be transported, where the field 
gradient is steep, as a result of dipole induction. Fur­
thermore, we may also anticipate that stored energy of 
ionars and ergonars (Chapter XIII) in a closed electric 
circuit may convert their ene.rgy and interacl witb 
surrounding material. Thus, radiating structures 
should deve.lop under the influence of positive as well 
as negative polarization of a lesion. h is possible or 
even likely that the physicochemical potential of a 
degrading tissue must change its polarity to develop 
"complete" radiating structure s. These structures re· 
present, in the author's opinion, a special type of scar tissue induced by tumoural degradation and liberation 
of energy over a BCEC. This hypothesis also explains 
why radiating strucrures sometimes include islands of 
electrophoreticaUy "displaced " tumour cells close to 
t.he tumour surface but not in the distal parts of the 
radiating structures. The "ebb and now" of moving 
anions and cations over a BCEC is probably a necessity 
for the development of aU kinds of scar tissue. Proofs 
for the validity of this theory will be presented later in 
this chapter. They conform with the biokinetic expla­
nation offered for corresponding structura l changes in 
the lung. C. Peritumoural changes 
of radiopacity 
In the breast, as in the lung, a radiolucent "A" zone (a 
decrease in x-ray absorption around a lesion) can 
sometimes be seen, sometimes not. Peripheral to the 
"A*' zone, a "B" zone can also sometimes be seen as a 
region of i.ncreased x-ray absorption. The "B" rone in 
Fig. XVI: 13. Skin thickening ncar a moderatel y well differ· 
entia ted adenocarcinoma or the breast (6S-year-old woman). Mammograph y shows two adjoining tumours (T), surround­
ed by radiating structures and an "A" zone. To the left of 
the nipple, indicated by a small mcul ball, are two clonaated 
opacities (8). These so-ailed skin thickeninp comspond to 
hydropic "8" zon<S in the luna (see poae 20) and retraction 
pockets in the pi~ (see paae 35). Two thick radiatina 
structures (L) extend to the "8" zones. The radiating struc­
tures correspond to bmdlae in the luna producina pleural 
remction pockets. BCEC in cancer of the breast 213 the breast appears most often, as will be seen, as local 
uskin thickening". The radiologic appearance of a radiolucent "A" and 
a radiopaque "8" zone, seen as uskin thickening " near 
breast carcinomas , has already been illustrated (Figs. XVI: I, 2, 8, 12). Fibroadenomas may also present 
with a radiolucent "A" zone surrounded by a radio­
paque "B" zone. Fig. XVI: 13 illustrates two adjoining 
mammary carcinomas surrounded by radia­
ting structures and a radiolucent "A" zone. Two distal 
opacities, which would usually be called "skin thick­
ening", appear similar to the hydropic "B" zone close 
to the pleura in the lung. Two thick structures lead to 
each of the densities. The left one is similar to a 
lamella (see Fig. III: 27) in the lung. The carcinoma in Fig. XVI: 14a-c is quite differ­
ent. Although the radiating structures appear numer­
ous and similar, ''An and "B" zones are not evident. "Skin thickening" and skin retraction are absent. Pe-
214 BCEC in cancer of the breast l 
Fig. XVI: 14. Radiating structures without"A" or "B" 
zones. Moderately well differentiated adenocarcinoma of the 
breast (68-yet>r-<>ld woman). Three mammographic projec­
tions (a-c) of the tumou: show numerous thin radiating 
strtlctures extending into ;~dj:~cent breast tissue. Addilional 
thin structures, circularly arr-.mged (arrows), can be seen in 
the tissue around the tumour ... A" and .. B" zones~ s.k.in re­
t:ra.ctioo and "skin thickening" arc not present. The tumour 
docs contain a central ro::us of calcificadoo . riplu:raJ to the tu.muur at'e some circularly arranged 
thin structures. The two major types of peri!umoural alterations of 
radiopacity, the radiating structures on one hand and 
"A" and "Bu zones on the other, have been brought 
together in this section in order to discuss possible 
causes of the presence of an "A" and "B" zone around 
some tumours and their absence around others, seem­
ingly without regard to the presence or absence of 
radiating structures. Discussion 
Previous chapters on the "A" 1.-ones in the lung consid­
er the possibility of local electroosmotic displacement 
of water. Air in alveoli should replace some of the 
tissue water in the "A" zone. Such a redistribution of 
water and air will appear radiographically as a local 
"halo" or "emphysema" , although no "real" tissue is 
necessarily lost. The radiolucent "A" zone and radiopaque "B" zone 
around mammary carcinomas are from this radiologic 
point of view very similar in appearance to the changes 
around certain lung lesions. The question is now: What is the background for the development of a perifocal, radiolucent zone 
around a breast cancer? Oedema around the edge of a 
breast lesion produces increased absorption of x-rays. The only possible material in the breast which can 
produce a decrease in x-ray absorption is fat. The 
appearance of a mammographi c "A" zone might then 
be explained as in the lune except on the basis of f•t as 
the low contrast medium. A general increase of fluid in the breast tissue is 
known to produce enlargement and hardening of the 
breast, e.g., in the premenstrual phase, or when re­
gional lymph nodes are blocked, or when cardiac 
pump failure increases venous and lymphatic pres­
sures in the breast. The nipple stiffens, enlarges and 
increases in prominence. The skin appears thickened 
(55). The possibility of relative outward movement of 
water from a positively charged surface has been treat­
ed in Chapter IX. In the periphery of the lung, a tumour produces 
stasis by blocking the flow of pleural and interstitial 
fluid from the periphery to the hilar lymph nodes. In 
the breast, lymph flows mainly from the areola and 
deep glandular tissues to the axilla and along perforat­
ing intercostal vessels to the anterior intercostal and 
retrosternal lymph nodes. The lymphatics of the breast intercommunicate ex­
tensively, so local stasis of lymph does not usually 
characterize mammary tumours. Neverthele ss, local 
stasis may be found occasionally, especially in the 
vicinity of the areola. The hydropenic adipose tissue 
around the tumour may then appear radiolucent be­
cause fat attenuates x-rays rather poorly. The develop­
ment of a hydropic "B" zone (cutaneous oedema) 
beyond the hydrope.nic "A" zone, on the other hand, 
requires balancing hydrostatic counterpressure. This 
counterpressure appears to develop most easily in the 
region close to the skin and the areola. In addition, the 
local forces causing cutaneous retraction over a breast 
tumour will contribute to the localization of the "B" 
zone water (see also Section J). Electric closed circuit interstitial transport of mate­
rial other than water should also be possible between a 
tumour and surrounding tissue. A corpuscular "B" 
zone may develop in this way either in the skin as 
another type of "skin thickening " or anywhere else in 
the tissues surrounding the tumour as a radiopaque 
structure oriented parallel to the tumour surface. Spe­
cial cases of such corpuscular "B" zones will be de· 
scribed in Sections F-1 and T. 
As in the lung, a radiolucent "A" zone around a 
breast tumour may also result from extensive capillary 
thromboses. The electric field induces thromboses 
near the tumour during its electropositive polarization. The thromboses can then be anticipated to produce 
dystrophic changes of peritumoural tissues near the tumour, yielding a structurally depleted region 
("halo" or "A" zone) around the tumour. Circular 
arrangement of vessels and development of septa in the 
surrounding tissue are part of the process and will be 
further treated in Section H. Interphase phenomena 
between "A" and "B" zones will be discussed in 
Section I. In the next two sections it will be shown that electric 
polarization can partially separate fat and water in an 
experimental analogue to a BCEC system. In this way 
we may find an experimental explanation of the perifo­
cal density changes seen as a radiolucent "A" zone and 
a radiopaque "B" zone. We will then see how a nega­
tive or positive polarization of a lesion will influence 
the perifocal density changes in different but predict­
able ways (Section F). D. Fat-water distribution: 
closed circuit effects and 
radiographic appearance 
in vitro 
The influence of an electrically closed and activated 
circuit on a mixture of fat and water was next investi­
gated. The development of differences of radiographic 
attenuation and changes in electric conductivity in a 
fat-water medium is illustrated in the following in vitro 
experiment. An aluminium ball was fiXed with glue to the centre 
of the bottom of a glass jar (Fig. XVI: 15). The inside 
of the periphery of the jar was covered with thin 
aluminium foil. Both the central ball and the peripher­
al foil were connected with a cable to the electrical 
charging device previously described for demonstrat· 
ing the orientation of corpuscular elements in an elec­
trostatic field (page 94). A layer 2 em deep of a 
mixture of 25 % lanolin and water was poured into the 
jar. [njtially, both terminals were grounded. A radio­
graph token of the jar with mammographic technique 
(Fig. XVI: 15 a) reveals the fluid is fairly homo­
geneous. Some hours after the application of a 500 V positive 
potential on the central ball against the grounded pe­
riphery, a new radiograph was exposed (Fig. XVI: 15 b). One broad radiolucent zone, about 10 mm 
wide (x), surrounds the ball while another zone, even 
more radiolucent and about 2 mm thick (y), is seen at 
the surface of the ball. When the contents of the jar 
were poured out, a thick solid layer of white fat sruck 
to the ball (Fig. XVI: 15c). This layer constituted 
most of the broad radiolucent zone. An inner layer, 2 
mm thick, corresponded to the inner radiolucent zone. BCEC in cancer of the breast 215 Fi1. XVI; IS. In vi1r0 mammographit analog~~e of a bmst, 
showing separation of fat from water in a closed electrk cir· 
cuit. Glass jar with aluminium ball glued on its bottom. The 
internal walls of the jar are covered with aluminium foil. A 
mixture of lanolin and water is poured into the jar. (a) Ra· 
diograph of the jar with mammographic technique when ball 
and periphery are short circuited. (b) After application of a 
500 V potential for three hours between ball and periphery, 
two radiolucent "A" zones developed around the baiL Zone 
x, about 10 mm broad, contained white lanolin. Zoney, 
about 2 mm across, contained yellow lanolin. The "A" zones 
in this example depend on the lower attenuation ofx-rays by 
fat than water. (c) Photograph of the ball covered with white 
ftrm lanolin after the liquid was poured out. Discussion 
The use of a 500 volt potential across the liquid is 
certainly not very close to physiological conditions. Appreciable separation of fat and water could, howev· 
er, also be accomplished after a couple of days with a 2 
volt potential between the electrodes. Electropho retic 
movements will of course take place also at low vol· 
tages and current densities. The time for the develop­
ment of structures secondary to polarization of a tu· 
mour can therefore not be neglected . It is known that 
the development of a tumour takes months or even 
several years. For the lungs, radiologic recognition of structure 
depends to a large extent on the differences between 
air and lung tissue in the absorption of x-rays. Lung 
tissue behaves radiographically like water. For the 
breast, the radiographic role of fat corresponds to that 
of air in the lungs. Most of the fat in the breast is 
already structured and would therefore not be expect­
ed to move like air in the lungs. Nevertheless , the 
development of an "A" zone around a breast tumour 
2 I 6 BCEC in cancer of the breast should be possible by the movement of water in rela· 
tion to immovable fat. Lipid, moreover, is not immov­
able, as will be shown in Sections F and J, which show 
lipid of fat cells mobilized , transported and accumulat­
ed within a closed circuit applied both in vitro and in 
vivo. First, however, we will illustrate, in a simplified 
way, the principle for conductivity changes which 
have been encountered in vivo in the lung (Fig. VI: 21) 
and in the breast on passing an exploring electrode 
through "A" and "B" zones. E. Local alteration of 
conductivity in a 
fat-water mixture 
When an exploring electrode passed from the "A" 
zone into the "B" zone (see Fig. VI: 21) in the tracings 
of electric potential in lung, occasionally the superim· Fig. XVI: 16. In vitro electric analogue of a 
breas1: "electroeardiographic" ampUtude dif­
fered in the "A" and "B" zones. Same ex­
perimenta l arrangemcnl as shown in Fig. XVI: IS for separation oflanoUn and water. A pulse generator produced small and large 
pulses, simulating an ''ecg". Electric poten­
tial was lraced al differcnl positions between 
the periphery of the jar and a movable elec­
trode. When the electrode enrered the ''A" 
zone, the amplitude of the pulses decreased 
suddenly. Electropho retically produced 
changes of conductiv ity can explain rhis de· 
crease. Compare also ecg changes in the "A" 
zone in the lung (Fig. XVI: 21) in an example 
of increased uA" zone conductiviry. chart 
writer 
posed ecg signal suddenly changed its amplitude. The 
subcutaneous reference electrode was grounded in 
these studies. An explanation for this phenomenon may be that 
local electrical conductivity has changed due to redis­
tribution of water, ions and molecules surrounding the 
lesion. The electrophoretic study of water and lanolin 
lends itself to ready illustration of this possibility. The 
experiment was arranged as seen in the upper part of 
Fig. XVI: 16. A "halo" or "A" zone was electrophoretically pro­
duced around the central aluminium ball in the glass 
jar containing 25% lanolin and water (see Fig. XVI: 15). A measuring electrode was fixed to a me­
chanical holder on a motor driven bar, which allowed 
the electrode to be moved evenly in the lanolin-water 
mixture as the tip moved from the periphery toward 
the surface of the ball. An ecg-simulating double signal 
was produced by a pulse generator at the distant elec­
trode in the water-lanolin solution. This signal was 
received by the exploring electrode, relative to the 
grounded periphery of the jar, as seen charted in the 
lower part of Fig. XVI: 16. When the electrode was 
moved evenly from the periphery to the ball, the 
amplitude of the induced signal suddenly decreased , as 
expected, when the "A" zone was entered. Similarly in the human lung, when an electrode 
explores through the radiologica lly observed "A" and 
"B" zones, sudden change of amplitude of the ecg at 
the zonal interface can therefore be explained as indi-mov1bh me•surlng 
electrode 
eating that the water-ion composition and concentra­
tion differ in the two zones (page 64). In the experiment with water-lanolin , the amplitude 
decreased in the "A'" zone, where concentration of fat 
was high. In patients with mammary carcinomas, amplitude of 
a superimposed ccg should be expected to decrease 
when the exploring electrode passes through an "A" 
zone around the tumour. In the present small series of 
breast cancers this finding has, however, not yet been 
verified. Electrode sites were not selected with the 
intention of obtaining a superimposed, disturbing ecg 
signal. "A" zone conductiv ity in the lung is not liko that 
predicted for the breast. The pulmonary hydropertic 
"A" zone showed a. higher ecg amplitude than the 
hydropic "B" zone,. a result indicating in the lung 
higher conducliv iry iin the "A" than in the "B" zone. Discussion 
These experiments show in vitro radiographic and 
electrophys iologic correlations with the relative separa­
tion of fat and water in a closed electric circuit. These 
results also form indirect evidence for the existence of 
biologically closed electric circuits. The fat phase in the experiment with lanolin and 
water has a lower conductivity than the water phase. The water phase obviously carries a higher ionic con-
BCEC in cancer of the breast 217 centration. Tissue structures of the "A" zone in the 
lung, on the other hand, present relatively higher 
conductivity than those of the "B" zone. This seeming 
paradox is possible despite the fact that the amount of 
pOOrly conducting air must be increased in the "A" 
zone, as judged by its low attenuation of x-rays. If the 
"A" zone is produced mainly by clectr00$motic out­
flow of water to the "B" zone, ionic concentration in 
the "A" zone nevertheless may be relatively higher in 
the conducting channels of the "A" zone than in the 
"B" zone. The influence of an activated closed electric circuit 
on distribution of water and fat in dog and human fat 
tissue is presented in quantitative and histologic ex­
periments in the next section. F. Closed circuit transport s 
of fat and water in mammary 
fat tissue 
Material for these in vitro and in vivo experiments was 
mammary fat tissue from four dogs and recent mastec­
tomy specimens from two women. 1. Method 
The cylindrical mid-part of a 10 ml plastic syringe was 
used as an electrophoretic chamber. This chamber was 
filled to a length of about 2.5 em with an excised piece 
of mammary fat tissue. The flat ends of two plungers 
weco each covered with platinum foil connected to a 
platinum cable and then inserted into the cylinder. As 
the plungers were pushed toward each other, air was 
allowed to escape through small perforations in each 
plunger. In this way most of the air could be removed 
from the specimen of tissue. Tbe cables were then connected to an electric De­
power unit and a milliampere meter. Photographs and 
soft tissue radiographs were taken of the specimen 
before and after different time periods of electrophore ­
tic treatment. The sample was later frozen in the 
cylinder, which was divided lengthwise in two. One of 
these partS was saved for histological sections. The 
other part was subdivided crosswise in two approxi­
mately equal parts, one from the electropositive and 
one from the electronegative field. Water and fat con­
tent was determined from each of these parts as fol­
lows: 
After careful weighing , the samples were placed in 
IIOOC temperature for 16 hours, by which time all 
water had evaporated. Dry weight was then deter­
mined. Chloroform was used to dissolve the fat materi-
218 BCEC in cancer of the breast al. By ft!tering the solution, nonso1uble material was 
then removed. This step was repeated three times. The fat content was finally determined by weighing 
after evaporation of the chloroform. In vivo electrophoresis was also performed in four 
dogs under general anaesthesia with sodium pentobar­
bital. A inxdlc wa~ u::tOO 1.0 pla\.--c: two platinum string 
electrodes through the skin into subcutaneous mam­
mary fat tissue. Mter DC voltage was applied between 
the strings, photographs of the experimental area were 
taken at intervals. Blocks of tissue were later excised 
around the electrodes for histologic sections and deter­
minations of fat and water content. 2. Results 
Human breast fat (Fig. XVI: 17) is seen in an electro­
phoretic chamber photographed during application of 
40 volts between the electrodes and after 3, 28 and 31 
coulombs (a-<, respective ly). A zone of fat-like materi­
al, semitransparent to light and of yellow to yellow-red 
colour, developed near the anode to the right and 
moved to the left, increasing in thickness . This "liquid 
fat" is seen in the radiograph (Fig. XVI: 17 e) as a zone 
of decreased x-ray attenuati on. In addition to the 
broad "liquid fat" zone, some thin light zones also 
developed in the specimen. The latter became bright 
yellow tO brown in the cathodic region. Fig. X VI: 17 d 
illustrates histologic sections (haematoxylin-eosin ) 
through a "liquid fat" zone. Empty "fat pOOls" with 
membrane-like delineation of some dark material have 
developed across the specimen. The pools, surrounded 
on both sides by small and partly flat cells of fat, 
contained "liquid fat", which partly flowed from the 
specimen when it was removed from the electrophore­
tic chamber. The fat zone never crossed the mid-part 
of the chamber in its move from the anode toward the 
cathode, even though electrophores is was continued 
for 20 and 40 days in two of the experiments. The 
experiments showed little cwrent after the first day, 
mainly because of anodic dehydration and gas produc­
tion at the surfaces of the electrodes. In vivo electrophoresis in a dog under sodium pen­
tobarbital anaesthesia is shown in Fig. XVI: 18a. Two 
platinum string electrodes were inserted percutaneous ­
ly in the breast fat so that they were 20 mm apart. At 
10 volts, a mean current of 32 .uA crossed the tissue for 
two hours, corresponding to 0.23 coulombs. By this 
time the tissue around the cathode was red and swol­
len. Tissue around the anode was seen to be grey and 
shrunken. A clear fluid came out on the skin around 
the cathode. This fluid could be sucked up with a 
syringe through a thin cannula. When the content was 
blown out on a water surface, some of the material 
floated in droplets as liquid fat. \. .-
,. ' ·; ' •' 
• j 
~· ~ J, .. J~ 
/'-'!. \ . ' I \ , 
\ \i ~ l ... '· ( .t 
. ,. it. ' .. 
.• ., 
·( 
•I \.!---... 
'"" . ' . e / .. ~~,.'~'\. --I . :, )• . .· I' .. 
J-----+ . ' -· ', 
Fig. XVI: 17. Movement of human breast fat in an electro­
phoretic chamber between two platinum electrodes. Cathode 
to the left, anode to the right. 40 V electrode potential differ­
ence. (a) 3 coulombs, 2 min. (b) 28 coulombs, 14 min. (c) 31 
coulombs, 205 min. The relative increase in time depends on 
electrOO$JDOtic, anodic dehydr.ation. A fat zone moves from 
right to left, increasing in thickness (photographsa-c ). Soft 
tissue radiograph e shows the low x-ray attenuation of fat as a 
white band, which corresponds to the fat zone in c. (d) A composite of three photomicro graphs of t.he fat zone shows 
empty pools surrounded by smaU fat cells and dark material. Electronegative breast far moves initially from cathode to an· 
ode, bm reverses irs uanspoct under the influence of the 
strong acidity in the anodic field, which makes the fat in the 
anodjc field electropositive. An equiljbrium is t.hen obtained 
between ele<:tronegative and ele<:!topositive fat in t.he mid· 
part of the ele<:trophoretic chamber . BCEC ia cancer of the breast 219 a -+ 
Mter incision with a knife, the tissue around the 
cathode appeared brown-red and flabby, while around 
the anode the tissues were grey and dry (Fig. XVI: 18 b). The distribution of water and fat in the cathoruc and 
anodic halves of each specimen was analyzed (Table 
XVI: 1). Fig. XVI: /8. In vivo movement of mammary fat aod water 
under the influence of direct electric current. (a) Platinum 
string electrodes were introduced percutaneously into the 
subcutaneous breast fat tissue of an anaesthetized dog. After 
23 coulombs at 10 V the tissue was swollen with leaking li­
quid fat around the cathode (-)and shrunken around the 
anode (+). (b) A se<:tion through the tissue be!Ween the elec­
trodes shows red-brown, swollen tissue around the cathode 
and grey-white , shrunken tissue around the anode. In vivo, 
fat moves as shown in vitro (Fig. XVI: 17). An undisrurbed 
supply of tissue fluid makes the cathoruc tissue swell due to 
electroosmotic transpon of water. The table includes electrophoretic results from in vitto 
and in vivo experiments on dog breast fat tissue and 
from in vitro resu.lts on human breast fat tissue. The 
figures in Table XVI: I show the per cent of water and 
fat based on weight in relation to the total fresh weight 
of the cathodic and anodic halves of each specimen. Water was more concentrated in the cathodic piece 
of tissue and fat more concentrated in the anodic 
piece. This tendency was the same in in vitro speci­
mens of dog and human breast fat, and also in in vivo 
dog skin and dog breast fat. Control determinations of fat not subjected to elec-
Table XVI: I. E"ltclroosmosis arul fat ekctropJwresis: per ceru of Wl.lter and fat in 1ht cathodic and anodic halves of experimental 
s~cimnts 
Cathodic Anodic Unt1eated Voltage, time, 
Specimt:n ~.tf balf controls amount or current 
Breast fat (dog) H20 7.9 6 .t 10 V, 48 hQUf$ 
in vitro Fat 73.5 79.t = 173 coulombs 
H,O+fot 81.4 85.2 
Residual 18.6 14.8 
Breast fat (dog) H,O 26.4 21.7 10 V, 2 hours 
in vivo Fat 49.8 58.1 = 23 coulombs 
H20 +fat 76.2 79.8 
Residual 23.8 20.2 
Brtast skin (dog) H,O 49.1 41.4 10 V, 2 hours 
in vivo Fat 16.7 32.7 • 23 t;Oulombs 
H20+fat 65.8 74.1 
Residual 34.2 25.9 
Bmo.sl fat (dog) H20 9.3 8.8 No currem 
in vitro Fat 63.2 63.6 
H20+fal 72.5 72.5 
Residual 27.5 27.5 
Breast fat (human) H20 13.4 11.5 10 V, 48 hours 
in vitro Fat 79.4 82.6 • 180 coulombs 
H,O+fat 92.8 94.1 
Residual 7.2 5.9 
Breast fat (human) H20 6.2 No current 
in vitro Fat 83.8 
H20+fat 90.0 
Residual 10.0 
220 BCEC in cancer of the breast Fig. XVI: 19. Histologic ap­
pearance of dog mammary 
fat tissue after influence of 
direct cu.rrent and formalin 
fixation, which dehydrates 
the tissue. (a) In vivo and (c) 
in vitro cathodic tissues after 
electrophoresis show 
shrunken and small fat cells 
and occasional interstitial fat 
droplets. (b) In vivo and (d) 
in vitro anodic tissues from 
rhe same experimentS show 
large, distended or ruptured 
fat cells. In addition, Fig. d 
shows small fat cclb to the 
right where the tissue has 
been in direct con.tact with 
the anode. Irregular, granul· 
ated material with a forked 
appearance inc represents 
early stages of formation of 
cathodic 6brous tissue (see 
Sections K-M). tric current showed only slight differences of fat and 
water content in two dog mammary fat specimens of 
equal weight. The sum of fat and water in the control 
specimens was 72.5% of the total weight, meaning 
that the residual "matrix" in the dog fat tissue was 
27.5% of the total fresh weight. The sum of fat plus water in the electrophoretic 
experiments revealed larger "matrix residual" in the 
tissues of the specimens of the cathodic fields than of 
the anode. These relations of fat, water and residual \ ·-. •) 
l~ j? ., .....__,__ __ . -,,, ..:. . '$, ..... 
' -• • ;,.o.c ·-\ ... ' ~ \ ;. -· 
~ ·"'-{. \,-\. .. ~ 
I 
"matrix" material become particularly interesting 
when the morphologic structures are studied histologi· 
cally. Histologic sections (after formalin fixation) are 
shown from in vivo (a and b) and in vitro (c and d) 
electrophoresis of dog breast fat tissue in Fig. XVI: 19. Figs. a and c show fat cells from cathodic parts, band 
d from anodic parts of the specimens. Cathodic cells 
appeared small and shrunken, especially near the cath· 
ode. Stainable fat droplets could also be seen in the 
BCEC in cancer of the breast 221 cathodic interstitial tissue outside cells. Fat cells 
around the anode (b, d) ap,peared large and distended, 
except for the material immediately adjacent to the 
anode, where the cells were small (d). It also looks as if 
many cells or cell groups ruptured in the main part of 
the anodic tissue to an extent which is not observed in 
fat tissue from the cathodic tissue. Appearing like forked dendrites in Fig. XVI: 19c is 
some irregularly structured, granular material. Some 
similar materiAl parallel to the cathodic surface of the 
specimen is also seen in Fig. XVI: 19a. These materi­
als are interPreted to be early stages of transformat ion 
of blood. 3. Discussion and conclusions 
The electrophoretic transpc>rt of water and fat in these 
experiments is complex and not easily explained. The 
conditions are also not exactly the same in the in vivo 
and in vitro experiments. We will first consider the in 
vitro studies: 
It is evident that fat leaves cells in the cathodic 
region through cell membranes which look intact to 
light microscopic examination. The exit of fat from 
cells leaves them appearin,g small and shrunken. Ca­
thodic fat droplets appear in the interstitium and later 
disappear from this region, which becomes pale and 
yellow. This fat moves toward the anode, shown by 
the analytic results, indicating that a bulk portion of 
original fat material should be electronegative. Inter­
stitially migrating electronegative fat then seems to 
enter disrupted anodic fat cells, explaining their dis­
tension and the many sites of what appear to be broken 
cell membranes. The fat-water ratio in the cathodic 
region is now lowered d11e to loss of fat and some 
increase in electroosmotic accumulation of water, ac­
cording to the analyses. The ratio is corresponding ly 
elevated in the anodic regi.on due to inflow of electro­
negative fat and electroosmotic loss of water. What happens, then? How can the liquid fat zone in 
vitro be explained? It starts to develop close to the 
anode and moves, increasing in thickness, toward the 
mid-part of the electrophoretic chamber. Anodic fat in vitro and in vivo very close to the 
anode must leave the fat cells, because these cells 
appear small. Electronegative fat may partly be elec­
trophoretica lly pulled out and become mixed with ca­
thodic fat, which is moving toward the anode. This 
explanation may account for the presence of freely 
floating fat at the surface of the anode both in in vivo 
and in vitro experiments- Fat disappears from the 
anode probably because the anodic acidity, by proton 
liberation, should change the polarity of fat from elec­
tronegative to electroposi tive. Some of this fat can be 
expected to move in the direction of the cathode. As 
222 BCEC in cancer of the breast the electrophoresis continues, electropOSitive fat will 
be produced and follow the migration and diffusion of 
protons. This transport will leave anodic, small cells 
behind and produce a zone of increasing distension of 
fat cells where cathodic electronegat ive and anodic 
electropos itive fat meet. The increasing thickness of 
this zone, the distinct anodic and cathodic interphases, 
and tendency to reach the mid-part of the electric field 
can be explained in tltis way. When the turgor pres­
sure is high enough, fat cells will rupture and develop 
fat pools surrounded by small cathodic and small an­
odic fat cells. This explanation of fat movement in the 
electrophoretic chamber is in agreement with the well 
known fact that a compound can change its polarity 
according to surrounding acidity or alkalinity . Water can easily disappear in vivo by electroosmosis 
from the anodic region, which therefore shrinks. Wa­
ter will accumulate in the cathodic region, which 
therefore swells. These phenomena are influenced by 
the local circulatory conditions in vivo, which are 
eliminated in vitro. Otherwise, the same explanation 
holds for movements of fat and water in vivo as for the 
movements in vitro. Both the in vitro and in vivo specimens had to be 
ftXed in formalin for the preparation of the histologic 
examination. During the process of ftXation, formalin 
dehydrates tissue specimens. This dehydration is the 
reason for the seemingly contradictory appearance of 
swollen cathodic tissue in vivo and shrunken cathodic 
fat cells without distended spaces in the histologic 
preparations. G. Peritumoural water 
and fat, including atrophy of 
fat adjacent to electronegative 
mannr.nary carcunoma s 
Considerable difflculties arise on attempting to deter­
mine the regional amount of tissue water in the lung. Opening the pleural space, for instance, alters disten­
sion of tissue and vascular perfusion, thereby radically 
changing the local distribution of tissue water. In the breast, a subcutaneous and therefore relative­
ly accessible .organ, the conditions are more favourable 
than in the lung for such determinations. Attempts 
were therefore made to determine the relative amounts 
of water and fat in the breast tissue around different 
breast tumours as soon as possible after mastectomy. Sites for excision of pieces of tissue around breast 
tumours were selected by means of pre-and postoper­
ative mammography. Pieces of reference tissue were 
also excised from regions of breast tissue appearing grossly normal. The different samples were weighed 
and dried at a temperature of 11o•c for 16 hours. The 
per cent loss in weight was then determined as an 
expression of the relative water content. The relative 
fat content was then determined by dissolving the 
material in chloroform, and filtering and drying the 
fat-chloroform solution, as previously described (Sec­
tion F). Specimens from two patients will be illustrated. Tbe 
mammary carcinoma of an 80-year-<Jid patient (G. P., 
Fig. XVl: 6) presented with thin radiating structures 
and also circular tissue structures about 2-4 em from 
the surface of the tumour. The radiographic density of 
the tissue inside compared to outside the circular 
structures did not show any definite differences. The 
electric potential of the tumour was also measured 
(Fig. XVI: 7). Fig. XVI: 20a shows a radiograph of a breast carci­
noma of a 60-year-<>ld woman (B.S.). Some radiating 
structures are evident at the tumour surface. As in the 
previous case, the surrounding tissue shows circularly 
arranged structures but no radiographically clear 
change in density, such as an "A" zone. The profile of 
electric potential of this tumour showed intratumoural 
negative deflections (Fig. XVI: 20b) similar to the 
previous case. The potential in the centre of the tu­
mour was relatively elevated and even slightly positive 
in relation to the surrounding breast tissue. Mter operative removal of these two carcinomas, 
their relative content of fat and water was determined 
both close to the tumour and in distant parts of the 
same breast, which presumably were not affected by 
the tumour (Table XVI: 2). nach ol the two subjects shows the same findings: 
relatively higher wat.er content and lower fat content 
close to the electronegative tumour compared to dis­
tant normal fat tissue of the breast. The fat-water ratio 
close to the two electronegative tumours is similar to 
the ratios produced in vitro in human mammaty fat 
Table XVJ: 2. FQt-water tonteni of brtast tiss~tt Qround two 
eleccronegarive mammary carcinomas: per cent of toea/ wtighc 
aosc: to 
tumour Peripheral 
Pari em surface tissue 
G.P. H20 14.1 7.2 
(Figs. 7.6 
XVI:6, 7) Fat 77.2 86.9 
86.4 
B.S. H,O 8.8 5.2 
(Fig. 11.8 5.4 
XVI: 20) Fat 71.2 78.2 
72.8 78.6 b 
Fig. XVI: 20. Breast carcinoma analysed for fat and water 
content of surrounding mammary lissue. (a) Mammogram, 
60-year~ld woman (8. S.). Radiating ard circular structures 
are evident without clearly visible changes of density such as 
an "A" zone. (b) Profile of electric potential through the tu· 
mou.r shows negative potential in the periphery of the tu· 
mour and slight elevation of potential in the centre, com­
pared to surroundjng noncancerou s breast tissue. Ecg is su· 
perimposed on the tracing. Table XVI: 2 shows analysis of 
fat and water from th.is breast (B.S.). tissue and in vitro and in vivo in dog mammary fat 
tissue adjacent to the electronegative electrode (Sec­
tion F). These two cases may therefore represent the appear­
ance of true perifocal oedema around electronegative 
tumours. As was shown in the studies of electric potential, a 
mammary tumour may also present an elevated elec­
tric potential in relation to surrounding tissue. In these 
cases a clear radiolucent "A" zone could be seen. Fat-water analyses of the tissues around such tumours 
should presumably show a relatively lower content of 
water and higher content of fat. As of this writing, 
however, no such specimens have yet been analyzed. Discussion and conclusions 
Water moves in an electric field from the electroposi ­
tive to the electronegative side, while fat moves in the 
opposite direction, according to the analysis of in vitro 
BCEC in cancer of the breast 223 ~ ..... ~\ . ·I 
... ~ 
.,..._ :» ... ' ' 
and in vivo electrophoresis of breast fat tissue in Sec­
tion F. 
Studies of human fat tissue adjacent to two elect.ro­
negative carcinomas of the breast, compared to distant 
fat in the same breast, have shown that the relative 
amount of fat and water in these regions corresponded 
to what was found in the electrophoretic experiments. This result is consistent with and may therefore indi­
rectly point to the possibility of spontaneous e.lectro­
phorcsis and electroosmosis in vivo over a BCEC. Of equal interest is the observed experimental 
shrinking of fat cells adjacent to the cathode and the 
"atrophic" appearance of fat cells around the anode. It is now relevant to review a well-known but as yet 
unexplained structural phenomenon , which develops 
adjacent to tumours in fat tissue. Carcinomas in the 
breast, in the subcutis or in other sites of adipose 
tissue often show what pathologists call "atrophic" fat 
cells adjacent to the surface of the tumour (89). Such a case is shown in Fig. XVI: 21. This histolo­
gic section through a breast cancer shows small, 
"atrophic" fat cells close to the tumour tissue. In the 
upper right-hand part of the figure the fat cells are 
larger and almost normal in size. Presently an explana­
tion for the atrophy of peritumoural cells is lacking. In 
the author's opinion, a spontaneous polarization of a 
tumour in relation to its surroundings should be capa· 
ble of producing peritumoural fat atrophy as a conse­
quence of fat mobilization and transport over a BCEC. The spontaneously atrophic, peritumoural fat cells are 
characteristically small. Their walls are even. In these 
respects the peritumoural fat cells are most similar to 
the "atrophic" fat cells adjacent to the anode in an 
electrophoretic experiment. 224 BCEC in cancer of the breast Fig. XVI: 21. "Atrophic" 
fat cells adjacent to a hu­
man breast carcinoma, his· 
tologic section. Also ob­
serve large numbers of 
white blood cells in the tu­
mour and in adjacent fat 
tissue. (Photograph cour­
tcsyofDr I. SOmegi, Ka­
rolinska Hospiutl, Stock­
holm.) H. Circular displacement of 
tissue structures around 
breast tumours 
Circular displacement and narrowing of vessels have 
been previously described around lung tumours 
(Chapter Ill). Similar radiographically visible struc­
tures have also been observed and demonstrated (Figs. XVI: I, 4, 6, 20) around certain breast tumours. The 
basic morphologic differences between the two organs 
are of considerable importance in the evaluation of 
these structures. As has been pointed out earlier, compression is 
often applied against the breast in mammography, 
which may displace structures considerably. In xeroradiography, a mammogram can be obtained 
without compression technique. Such a xeroradiogram 
is seen in Fig. XVI: 22, where a small carcinoma 
resides close to the chest wall. A preoperative stereo­
taxic needle biopsy and electric potential study re­
vealed an electronegative mammary carcinoma . The 
small tumour is surrounded by radiating strucrures 
and concentric arrangements of curved linear struc­
tures, which all seem to have their centre in the tu­
mour. Concentric arrangement of structures can also be 
recognized frequently in ordinary mammograms (e.g., 
Figs. XVI: I, 4a, 6a, band 14 b). T·o explain the development of circular structures 
around a breast tumour, once the effect of external 
compression can be excluded, an activated BCEC 
should be considered . This mechanism is capable of Fig. XVI: 22. Xeroradio­
graph of a small carcinoma 
of a breast without the use 
of external compression 
technique. Concentrically 
surrounding the: tumour 
arc many radiating and cir· 
cular structures . After 
stereotaxic needle biopsy 
for cytologic diagnosis of 
this nonpalpable tumour, a 
metal dip was placed in its 
centre as a guide to the 
surgical excision. producing anionic, cationic and water transports be­
tween a tumour and its surroundings. Moreover, it is 
easy to recognize that secondary biologic effects will 
also take place within a BCEC, contributing to the 
development of circularly arranged structures. Thus, 
thrombosis of capillaries will take place in the sur­
roundings of a polarizing tumour over a VICC (Chap­
ter XIV). Such thromboses, developing during an 
electropositive phase of the tumour, should produce 
local dystrophic changes in the poorly nourished tis­
sue, which will yield due to retractive forces in the well 
nourished surrounding tissue. This mechanism should 
contribute to circular displacement of tissue, as has 
also been observed in the lung (Figs. III: 30b, 34b). During an electronegative phase of a polarizing tu­
mour, a net inflow of water toward it will increase local 
water pressure and thereby further contribute to the 
circular displacement of structures (Figs. XVI: 6, 20, 
22). Broad, circularly running structures of a different 
origin may be identified around a tumour as a result of 
electroosmotic transport of water. Such a collection of 
water then represents what has previously been de­
fined as a hydropic "B" zone. Such structures were 
shown to disappear in the lung when air entering the 
pleura changes the flow conditions in the lung (Chap­
ter III, Section D). Fig. XVI: 23 shows a correspond ­
ing situation in the breast. This patient's xeroradio­
graph (Fig. XVI: 23 a), obtained without compression 
technique, shows broad circular segments in the tissue 
surrounding the carcinoma. These circular structures 
could not be demonstrated on radiography of the sur­
gically removed breast (Fig. XVI: 23b). This result is 
in accord with the disappearance of a hydropic "B" 
zone in the lung when the pleura is opened. The local 
accumulation of electroosmotically transported flwd 
producing such a "B" zone (a special case of a circular­
ly arranged "structure") requires, of course, an exact 
balance of interacting forces, which differ in vivo and 
in a surgical specimen. Peripheral displacement of tissue structures during 
an electropositive phase of the tumour should be con­
siderably enhanced during a phase of electronegative 
polarization. An electroosmotic inflow of water toward 
til~ t\!mour, causing perifocal ~ema, could then sim­
ply move tissue structures outward as a consequence of 
locally increased turgor pressure. Thus, in cases of 
true perifocal ~ema, as in the patients shown in 
Table XVI: 2 (Figs. XVI: 6 and 20), very well devel­
oped circular structures can be seen radiographically. They can also be influenced and change their appear­
ance by external compression. Conclusions 
It seems altogether plausible that the development of 
circular tissue struc~ures around certain breast and 
lung tumours involve similar mechanisms. Polariza­
tion of tissue over a BCEC as the common mechanism 
explains the transporting of materials and secondary 
biologic tissue changes which can satisfy most of the 
requirements for the production of circularly arranged 
structures in both breast and lung. We will now take .a closer look at some other struc­
tural details in the breast encountered in patients with 
breast cancers. We will start with a short description 
of the appearance and developme .nt of arches, which, 
when appearing in a row, form an arcade. I. Arches and arcades 
A large carcinoma in the breast with many radiating 
structures and small calcifications is shown in Fig. XVI: 24. A broad structUre extends from the tumour 
to the areola, which is somewhat retracted toward the 
tumour. The skin also shows increased radiopacity 
around the areola. A 6 mm broad, diffuse, semicircu-
BCEC in cancer of the breast 225 -
226 BCEC in cancer of the breast Fig. XVI: 23. Hydropic 
"8" zones producing 
uralse circular structures•' 
around a carcinoma of the 
breast. (a) Xerondio­
gnpb. A brust cancer (T) 
is surrvunded by arcs of 
uB" zx:oes, which appear 
as brood circular opolcities 
(arrov.-beadl ) near the tu· 
mour. Tb...: opacities are 
interpreted asloc:al oe· 
dema (hydropic '*B" 
zones), disappearins (b) 
after mastectomy. Fig. XV/:24. MammOtJflm 
showir.a arches around a 
carcinoma or the breast in a 
52-year-old woman. Radial· 
ing structures join into large 
arches, givina the tumour 
and surroundins tissue an 
appearance like the cut sur· 
face of a citrus fruit. Retrac· 
tioo of the nipple, mkroeal· 
cifications and a radiolucent 
u A.., tone: are all cviden t . The bond·shoped density to 
the kf: is believed to be a 
skin fold due to compreWc>n 
of the breast. (Mammosram 
counesy of Prof. 0. T ev~v 
and Prof. M. Grunevski, 
University of Skopje, Yu· 
goslavia.) Fig. XVI: 25. Many ndi­
ating strucrures appear as­
sociated with relatively 
SfiUUiarches.Manorno­
grarn, undifferentiated 
carcinoma, 74-year-old 
woman. At the interface 
between an .. A" zone and 
a local us" zone, a row of 
small arches forms an ar­
cade (arrowheads ), 
through which some radi­
ating structures pass. lar density in the left side of the breast is probably a 
skin fold produced by the compress ion of the breast 
during radiography. A radiolucent "A" zone is particularly prominem 
below and to the left of the tumour. Radiating struc­
tures diverge from the tumour but arc back to rejoin so 
as to produce arches, corresponding to what has been 
described around lung tumours (Chapter rll). These 
arches combine to form together an arcade in the 
tissue Z to Z. 5 em from the surface of this tumour. The 
tumour and the surrounding tissue appear rather like 
the cut surface of a divided citrus fruit. The number 
and size of the arches correspond roughly to the num­
ber and distances between radiating structures. To the 
immediate left of the illustrated tumour, adjacent 
are-hes can be seen to shar~ one radiating structure . When a tumour has a large number of radiating 
structures, the arches appear correspondingly smaller 
(Fig. XVI: 25). In this patient with breast cancer a 
radiolucent "A" zone is seen above the tumour. The 
"A" zone ends at a sharp borderline with some small 
arches forming an arcade against the peripheral, local 
opacity of a "B" zone. Some thin radiating structures 
also pass through the "A" and "B" zones. Arches and arcades as illustrated in Figs. XVI: 14 
and 25 appear in principle the same as the arches and 
arcades around lul\g tumours. They also appear the 
same as the arches and arcades which can be produced 
experimentally in vitro and in vivo in dog lungs (Chap­
ter XI). Discussion 
Arches forming an arcade peripheral to a tumour in 
the lung have already been explained (Chapter X). They are produced as interphase phenomena between 
an "A" and a "B" zone under the influences of physi­
cochemical forces of nonorganized materials as well as 
of electric field forces over a polarizing BCEC. It is 
likely that adsorption between adjacent fluid-matrix 
phases plays an important role in these processes. However, linear structures at an interface should not 
be confused with circular displacements of preformed 
structures, such as vessels and septa of fat tissue. As 
has been pointed out earlier, such structural displace­
ments may have several causes: perifocal tissue atro­
phy due to nutritional disturbances within an u A" 
zone, retraction forces of surrounding nonatropbic tis­
sue, and perifocal oedema during an electronegative 
phase of the tumour. Peritumoural fibrosis may shrink tissue, as suggest­
ed in Fig. XVI: 24, in which some radiating structures 
appear to have coalesced and retracted the nipple. Such shrinkage could contribute to the formation of 
arches in the tissue between pairs of radiating strUc­
tures. ln such an explanation, the broad radiating 
structures between the tumour and the nipple should 
be regarded as an equivalent to the lamella (Fig. XVI: 13) described around lung tumours (Chapter III, 
Section F). This parallel leads us to a short analysis of two well 
BCEC in cancer of the breast 227 known structural componen ts in breast cancer: so­
caJJed skin thickening and retraction. The parallel 
between breast and lung is opportune, because, in the 
opinion of the author, nearly identical mechanisms 
underlie peritumoural changes in the lung and in the 
breast. The mammographic changes are demonstrable 
as arches and arcades, retraction of the nipple, retrac­
tion of the skin and thickening of the skin. J. "Skin thickening" and 
retraction : a result of 
altered distribution of 
tissue water 
Local thickening and retraction of the skin of the 
breast is a well known clinical sign of an underlying 
pathological process, whether caused by trauma, infec­
tion, or as is usual, a carcinoma. The retraction of the 
skin is associated with juxtatumoural scar tissue, 
which for primary breast neoplasia is usually part of 
the mass of a so-called scirrhous carcinoma. Scirrhous carcinoma, which is the most frequent 
type of breast cancer, is characterized by the develop­
ment of peritumoural "fibrous strands" (radiating 
structures ) and hyalinization of peritumoural connec­
tive tissue. Scirrhous carcinomas may develop in the 
stomach, breast or other organs. They usually grow 
slowly. They are reported to consist of either anaplas­
tic cells or varying degrees of differentiation of adenoid 
structures (55). In the author's opinion, such cancers 
do not represent a specific type of cancer. A scirrhous 
cancer may instead be regarded as a particular trans­
formation of tissue induced by electrochemical polar­
ization of the tumour. The most common source of 
energy for such reactions is, in the author's opinion, 
the occurrence of degradation of tumour tissue. Such 
processes may in tum be more or less common in 
different kinds of tumours. Although scirrhous carci­
nomas are generally slowly growing, the biologic be­
haviour of their cells is not necessarily "benign". Even 
rapid, multifocal degradations coupled to injury-in­
duced healing and fibrous induration may keep the 
total amount of viable tumour tissue low for a relative­
ly long time. So-called prodvctive fibrosis and periru-
1111)Ural scar tissue of malignanr tunwun may in rhis way 
be regarded as an expression of spanca,.ous, incom­
plete healing of rhe tumour. The prerequisites 
for such reactions are energy-liberating processes, 
e.g., spontaneous necrosis, bleedings or infection, and 
the existence of a BCEC. The common observation of 
fibrosis forming around the intracardiac electrode and 
228 BCEC in cancer of the breast around subcutaneous pacemaker devices is in the au­
thor's opinion an in vivo "experiment" demonstrating 
this principle. The fibrous radiating structures, often long and 
straight, around a scirrhous cancer of the breast con­
tain different kinds of fibrous materials. Nonhygrosco­
pic collagenous fibres can be seen in histological sec­
tions as birefringent ftles. Hygroscopic fibrous materi­
al between these files is known to be an important 
constituent in scar tissue, according to Asthbury (7). Islands of cancer cells may be imbedded in fibrous 
material close to the surface of a tumour. The fibrous 
tissue of the radiating structures around a scirrhous 
breast cancer shows a striking similarity to other fi­
brous tissues, e.g., the scars of wound healing. Post-traumatic scar tissue retracts during certain 
phases of its evolution. Similar retraction can often be 
observed at the surface of lung peripheral to a lung 
tumour or to a pneumon ia healing with "productive 
fibrosis". Fibrous tissue tround a lung tumour may 
then produce "lamellae" and "retraction pockets" in 
the pleura, according to the mechanism described in 
Chapter IU, Section H. Given this parallel back­
ground, skin thickening and retraction superficial to a 
pathologic process in the breast may be e.xplained as 
follows: 
Local degeneration in a breast tumour leads tO local 
polarization. The polarization directs over the BCEC 
the growth of fibrous radiating strands. These strands 
contain partly collagenous fibrous elements, which are 
both nonhygroscopic and hygroscopic. Depending on 
the degree of water content, the hygroscopic material 
will stretch or shrink. When the tumour is electroposi­
tively polarized, a hydropenic "A" zone and a hydro­
pic "B" zone will be produced. In the hydropenic zone 
close to the tumour surface, the hygroscopic fibrous 
elements will shrink. When these elements extend to 
the subcutaneous tissue, retraction of the skin ensues. At the same time, water in the hydropic "B" zone will 
tend to collect in the retracted skin, partly as a ,result 
of the retraction forces on this tissue by the fibrous 
strands. The usually sharp border between the "thick­
ened skin" and the underlying tissue is then explained 
as a balancing effect between the local hydrostatic 
water pressure in the skin and electroosmotic forces 
tending to displace water outward within the BCEC. The increased water content in so-called skin thicken­
ing can in this way be described as partly a result of 
electroosmotic water transport and partly as "retrac­
tion oedema" (Fig. XVI: Z6). This skin "thickening" 
then corresponds to the pleural fluid which collects 
locally in the "retraction pocket" outside a fibrosing 
lung lesion. Whenever fibrous material is collected 
into a thick radiating structure (see Fig. XVI: 13), a 
lamella (Chapter III, Section F) is formed, which may 
pull the subcutaneous hydropic tissue so that this c 
Fig. XVI: 26. Skin "thickening" and retraction near a carci· 
noma of the breast. (a) Mammogram, 80-ycar·old woman. Skin is retracted and "thickened'• . A radiolucem "A .. zone is 
suggested, surrounding the tumour. Numerous radiating 
structures are evident. A "circular,. structure is seen to the 
right of tbe tumour. (b) As the tumoor polarizes, water will 
Oow outward by electroosmosis over the BCEC (electroposi· 
tive phase of tumour). This leads to development of a hydro­
penic '"A" zone and retraction of hygroscopic componen1 s of 
the fibrous material of the radiating structures. (c) Radiating 
tissue appears as half an arch on each side of the 
lamella. Two adjacent lamellae (or thick radiating 
structures ) will then produce an arcade. 11 may now be 
apparent that radiating structures and lamellae, arches 
and arcades, nipple and skin retnction and skin !hick· 
cning are to a large extent the result of identical bio· 
kinetic mechanisms, which appear differently in dif­
ferent surroundings. We will now consider the validity of the proposed 
explanations, first in terms of the retracting function 
of fibrous tissue. Histologic sections of breast tissue around scirrhous 
carcinomas show the birefringent collage.nous fibres as 
sometimes undulating (Fig. XVI: 27 a) and sometimes <+> 
Potential 
difference Radiating structures 
El.osm.
631928626-Biologically-Closed-Electric-Ci-Bjorn-Nordenstrom-pdf.txt
Summarize the following text section accurately and concisely. Maintain specific details and numerical information, and use anti-repetition mechanisms:

        In other cases no significant deflection of potential 
was found in relation to the surronding lung tissue. It 
is now apparent that electric potentials of mammary 
neoplasms in relation to their surrounding normal tis­
sue are similar to those of pulmonary tumours. The same types of M-and W ·shaped profiles of pOtential 
have been encountered in breast as in lung. Different tissues grow at different rates. A differ­
ence of electric pOtential should then arise as a "devel­
opmental potential" for abnormal tissue in relation to 
the "functional demand pOtential" of the surrounding 
normal tissue. If this reasoning is correct, then one 
might expect thar a rapidly growing tumour should 
present a correspOndingly large pOtential difference in 
relation to its surroundings. No such correlation bas 
yet been observed. On the contrary, at least in the 
lung, any histologic or cytologic type of tumour may 
pOSsess an electropOsitive, electronegative or zero pa· 
tential. Potential measurements therefore can not be 
used for differential diagnosis. This finding has led to 
the bypatbesis that a common denominator explaining 
the varying palarity and amplitude of tumour pOten­
tials in relation to surrounding tissue may be the de­
generative phenomena often encountered in rumours. A degr•ding process such as SpOntaneous necrosis or 
bleeding in lung tumours was earlier proposed to pro­
duce a nonspecific physicochemica l pOtential of tissue 
injury. The degrading of tissue in this view represents 
a dynamic process. Depending on the phase of the 
Fig. XVI: /0. Electropositive potential in a poorly differenti­
oted ductal breast carcinoma (55-year. old woman). (o) Mam­
mogram. The tumour is surrounded by an irregularly radio­
lucent "A" zone (dark halo) which in turn is surrounded by 
a radiodense "8" zone(white halo). No calcifications, rndiat· 
ing structures or circularly displaced structures arc seen in 
this case. (b) Tracing of potential through the tumour, which 
had a relatively electropositive centre. Ecg is superimpose d 
on tracing. Grounded reference electrode in the subcutis of 
the shoulder. b 
[smv 
11-8U586 Nonlntstrilm degradation, electric palarization may be either pOSi­
tive or negative. Regardless of palarity, BCEC chan· 
nels will aid in levelling of the pOtential difference. We 
do not know how intensely the pOtential difference is 
being generated or how efficiently the levelling of the 
potential gradient takes place. The magnitude of mea­
sured pOtential difference is therefore of little impar­
rance. We CAn only conclude that potential differences 
can be recognized between tissue regions, a prerequi­
site for electrogenic transpOrt of material between the 
two tissue regions. The total amount of transparted 
material does depend, however, on the factor of time. TranspOrt S of considerable amounts of material are 
therefore passible at relatively low gradients if the 
transparts take place over long periods of time. Three of the breast carcinomas (Figs. XVI: 8, 9, 10) 
showed pasitive pOtentials in relation to the grounded 
subcutaneous electrode. Two of these cancers also 
contained calcium depasits, which makes it likely that 
they (at least for some time) contained regions which 
were relatively electronegative, th. ereby attracting ca­
tions such as calcium ovrr a closed electric circuit. Next we will study the morphologic appearance s of 
altered tissue around and inside breast tumours. These 
alterations will then be compared with the appearances 
and biokinetic background of similar structures 
around pulmonary carcinomas. Finally we will show 
also that many of the structural changes in the breast, 
like those in the lung, can be produced by experimen· 
tal palarization of tissues over closed electric circuits. B. Radiating structures 
Infiltrating duct cell carcinomas accompanied by fi. brosis represent the most common type of breast can­
cer. The fibrosis commonly appears in a stellate radia­
ting pattern about these tumours. Although these so­
called scirrhous carcinomas represent 70 per cent of all 
mammary carcinomas (55), variably pronounced peri­
focal fibrosis is also seen around other rypes of breast 
carcinomas, i. e. , around medullary and lobular carci­
nomas. On the other band, any kind of breast cancer, 
including infiltrating duct cell carcinoma, may appear 
without fibrosis. Fibrosis in breast, moreover, is also observed 
around nodular mammary tuberculosis (65). Scleros· 
ing adenosis, fibroadenomas, chronic mastitis and 
healed fat necrosis are Qthcr bc-n. ign conditions pre­
senting "productive" fibrosis (55). Fibrosis around mammary carcinomas is, therefore, 
a common but nonspecific feature of the disease. The 
validity of the term "scirrhous carcinoma " as a charac· 
teristic feature of a specific type of carcinoma is there­
fore questionable. BCEC in cancer of the breast 211 The literature on breast cancer caJls radiating struc· 
tures by many names: spicules, cicatricial changes, 
sunburst changes, stellate strands, productive fibrosis, 
scirrhous changes, spiculae, spiculations, perifocal 
striate fibrosis, striae, productive fibrosis or hyalino­
sis, long radiating fibrous tentacles, "Krebsfiisse", 
dendritic margins and shaggy margins. Histochemically, radiating structures are character ­
ized by fibrotic material containing elastin, collagen 
and hyaline components (7, 20, 49). Near the tumour 
the radiating structures may contain blood vessels, 
extravascular white blood corpuscles and also carcino­
matous cells, often arranged in rows. Sometimes can­
cer cells are found isolated, forming discontinuous 
streaks or islands within the fibrotic tissue. Distant 
from the tumour the peripheral parts of radiating 
Structures usually contain only fibrotic material with­
out other cell or tissue components. For simplicity and 
accuracy of description, then, the nonspecific term 
radiating structures is here introduced as a term suitable 
for radiographic descriptions. Radiating structures are believed by some examiners 
to represent a reaction of tissue in the surroundings of 
a tumour and arc therefore not to be regarded as 
produced directly by tumour growth (20, 55, 68). The 
opinion has also been put forward that radiating scar 
tissue (and adenosis) is involved as a primary factor in 
the growth of breast cancer (6, 12, 34, 48, 67, 86) but 
this has been doubted by McDivitt, et a. (27), Haa­
gcnsen (47), Fenoglio and Lanes (33), Tremblay (90) 
and Azzopardi (9). An antigen-antibody reaction is also considered to 
take place around tumours ( 15, 25), leading to the 
formation of fibrin and hyaline as well as an amyloid­
like substance (89). Radiating structures do not develop from the tu· 
mour itself, according to von Albertini (3), but more 
212 BCEC in cancer of the breast Fig. XVI: II. Variable 
straightness of radiating 
structures. Mammograms 
of ductal breast carcinoma 
(66-year-old woman). Thin radiating structures 
extend several em into the 
tissue: surrounding the ru­
mour. The curved shapes 
of some of these structures 
appear '"relaxed''. likely arise from the surrounding tissue. Gullino and 
Grantham (46), Underwood (91), Douglas and Sbivas 
(28), on the other hand, all consider the fibrotic reac­
tion to be an expression of the biologic characteristics 
of the tumour tissue. The radiating structures around mammary carcino­
mas also contain a considerable amount of elastic tis· 
sue, compared with normal breast (28). In an excellent monograph on mammography, 
Hoeffken and Lanyi (55) state: "The stellate fibrous 
extensions are called cancer feet. This is not actual 
tumor tissue but rather a fibrotic reaction of adjoining 
breast. issue to the carcinoma. With extensive spread, 
however, even these fibrotic hyalinized bonds of con­
nective tissue may be invaded by tumor cells. So far 
there is no satisfactory explanation why such a desmo· 
plastic response is elicited by scirrhous carcinoma or 
what may be the histochemical or immunologic cause 
for this response. " The topography of the radiating structures around 
mammary carcinomas is of considerable interest. The 
structures are usually arranged in approximately 
straight lines perpendicular to the tumour surface. They may proceed far out into the surrounding breast 
tissue regardless of its basic structural arrangement. In 
this respect the radiating strucrures around certain 
breast tumours behave the same as the radiating struc­
tures around certain lung lesions. Tbin radiating structures of variable straighmess in 
two examples (Figs. XVI: II, 12) can be seen extend­
ing several em into the tissue around a breast carcino­
ma. The radiating structures in Fig. XVI: II are not 
quite straight and therefore appear "relaxed". In other 
cases the radiating structures appear straight, as if they 
were contracted. The carcinoma in Fig. XVI: 12 shows 
an abundance of radiating structures which are moder· 
ately straight. Peripherally they are thin. Close to the Fit. XVI: 12. Variable thickness or ~diatina struetures. Mammosram or a breast carcinoma (68-year-old woman). Many radiatina structures are mod~tel y straight. Some, 
however, look as if they retra<:t the nipple and adjacent 
"thickened" skin. They are thicker at the tumour than in 
their periphe~l parts. tumour they are broad. Some of them appear to be 
retracting a locally "thickened" pan of the skin. Discussion 
Radiating structures around mammary and pulmonary 
lesions appear similar. They develop more or less per­
pendicular to the surface of the lesions, regardless of 
the topography of the underlying normal structures. The presence of positive or negative polarization in 
relation to the tissue surrounding a breast tumour 
should, as in the lung, be able to produce radiating 
structures over the proposed biologically closed elec­
tric circuits. Electrophoretic and electroosmotic trans­
ports over a BCEC should build up the radiating 
structures from different available interstitial ions, 
nonorganized cells, debris and macromolecules, all or 
which then should be oriented under the innucnce of 
the electric field. ln this connection it should be point­
ed out that ionic material will not be the only material 
to move in the field. Nonpolar molecules which are 
not organized may be transported, where the field 
gradient is steep, as a result of dipole induction. Fur­
thermore, we may also anticipate that stored energy of 
ionars and ergonars (Chapter XIII) in a closed electric 
circuit may convert their ene. rgy and interacl witb 
surrounding material. Thus, radiating structures 
should deve. lop under the influence of positive as well 
as negative polarization of a lesion. h is possible or 
even likely that the physicochemical potential of a 
degrading tissue must change its polarity to develop 
"complete" radiating structure s. These structures re· 
present, in the author's opinion, a special type of scar tissue induced by tumoural degradation and liberation 
of energy over a BCEC. This hypothesis also explains 
why radiating strucrures sometimes include islands of 
electrophoreticaUy "displaced " tumour cells close to 
t. he tumour surface but not in the distal parts of the 
radiating structures. The "ebb and now" of moving 
anions and cations over a BCEC is probably a necessity 
for the development of aU kinds of scar tissue. Proofs 
for the validity of this theory will be presented later in 
this chapter. They conform with the biokinetic expla­
nation offered for corresponding structura l changes in 
the lung. C. Peritumoural changes 
of radiopacity 
In the breast, as in the lung, a radiolucent "A" zone (a 
decrease in x-ray absorption around a lesion) can 
sometimes be seen, sometimes not. Peripheral to the 
"A*' zone, a "B" zone can also sometimes be seen as a 
region of i. ncreased x-ray absorption. The "B" rone in 
Fig. XVI: 13. Skin thickening ncar a moderatel y well differ· 
entia ted adenocarcinoma or the breast (6S-year-old woman). Mammograph y shows two adjoining tumours (T), surround­
ed by radiating structures and an "A" zone. To the left of 
the nipple, indicated by a small mcul ball, are two clonaated 
opacities (8). These so-ailed skin thickeninp comspond to 
hydropic "8" zon<S in the luna (see poae 20) and retraction 
pockets in the pi~ (see paae 35). Two thick radiatina 
structures (L) extend to the "8" zones. The radiating struc­
tures correspond to bmdlae in the luna producina pleural 
remction pockets. BCEC in cancer of the breast 213 the breast appears most often, as will be seen, as local 
uskin thickening". The radiologic appearance of a radiolucent "A" and 
a radiopaque "8" zone, seen as uskin thickening " near 
breast carcinomas, has already been illustrated (Figs. XVI: I, 2, 8, 12). Fibroadenomas may also present 
with a radiolucent "A" zone surrounded by a radio­
paque "B" zone. Fig. XVI: 13 illustrates two adjoining 
mammary carcinomas surrounded by radia­
ting structures and a radiolucent "A" zone. Two distal 
opacities, which would usually be called "skin thick­
ening", appear similar to the hydropic "B" zone close 
to the pleura in the lung. Two thick structures lead to 
each of the densities. The left one is similar to a 
lamella (see Fig. III: 27) in the lung.
The purpose is to demonstrate the separation of fat and water in a closed electric circuit.
What is the purpose of the experiment with a mixture of 25% lanolin and water?
The author believes that potential measurements cannot be used for differential diagnosis.
What is the author's opinion on the use of potential measurements for differential diagnosis?
The author suggests that a common denominator explaining the varying polarity and amplitude of tumour potentials is the degrading process often encountered in tumours.
What is the author's explanation for the varying polarity and amplitude of tumour potentials?
The author concludes that the radiating structures around breast and lung tumours behave similarly, as they develop in an approximately perpendicular direction to the surface of the lesion.
What is the author's conclusion regarding the radiating structures around breast and lung tumours?
The author suggests that the development of circular displacement of tissue structures is due to electroosmotic transport and electroosmotic forces, which can cause the retraction of the skin and the formation of "A" and "B" zones.
What is the author's explanation for the development of circular displacement of tissue structures around breast and lung tumours?