Breast pathology in ancient human remains. An approach to mummified mammary gland by modern investigation methods

The breast has not been widely studied in mummified human remains, though it can be recognized in many ancient bodies. To the best of our knowledge, this is the first series of mummified mammary glands investigated by using modern technologies. Following this approach, we were able to find different alterations. Fibrocystic change appeared a possible diagnosis in two out of three subjects, whereas hyaline fibroadenoma could be suspected in one case. No firm conclusion can be drawn about the significance of microcalcifications, as they may be the result of a pathologic process or related to post-mortal/taphonomic phenomena. Additional data on larger mummy series, as well as the resort to compositional investigation methods (e. g., energy dispersive X-ray analysis), may be of help in understanding morphological details of ancient breasts. Nevertheless, the investigation methods of modern senology may allow an effective approach to ancient breast pathology, disclosing good morphological details in mummified specimens. Furthermore, the alterations induced by neoplastic diseases (fibrosis) should be easily identified in ancient breast by following this approach. To the best of our knowledge, paleopathological studies of the breast are extremely rare with only one case of lactational changes and one case of fibroadenoma described in literature. Histological investigation of mummified mammary glands demonstrates that the epithelial component does not survive postmortem alterations, differently from fibrous tissue. For this reason, a carcinoma should be easily identifiable in a mummified breast because of cancer-induced fibrosis, but breast cancer has never been reported in mummies to date. Aim of the present study is to gather the information obtained applying modern investigation methods to the mummified breasts of three women dating back to 15th, 16th, and 20th century, in order to find out features of pathological significance and validate the approach. Mammography performed in a 19th century mummy showed diffuse microcalcifications of the outer breast quadrants, quite similar to those observed in modern patients affected by epithelial proliferative lesions. Histology displayed collagen fibers diffusely colonized by fungal spores, and scattered roundish structures with only focal calcium deposits, Von Kossa-and red alizarin-positive. Such findings could not be certainly attributed to breast pathology or post-morten changes. The mummy of Margherita Sozzini (1511) did not undergo mammography, and CT scout scans did not allow to detect significant alterations of the breast. Histology showed fibrous tissue with empty, round spaces, possibly related to fat tissue. Given the age at death of the subject, the picture can be due to fibrous changes. In the mummy of Mary of Aragon (1568) mammography revealed multiple, bilateral microcalcifications, mostly on the right breast Microscopic examination highlighted a mixture of dense fibrous tissue and empty spaces possibly related to adipose tissue. Many fibrous walls of cysts were suggestive of breast fibrocystic changes. Single and grouped microcalcifications were also evident, appearing as rounded basophilic granules, with a slightly eosinophil center . In the upper outer quadrant of the right breast, a roundish formation (0.8 cm in largest diameter) of fibrous-hyaline connective suggested a fibroadenoma.