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Precancerous lesions: when and how they can turn into breast cancer or prostate cancer
A new study explains how some precancerous lesions in the breast and prostate can become invasive cancer and what role genes, immune cells and tissue around the tumor play.
How a precancerous lesion turns into cancer
A study published in 2026 looked at how certain precancerous lesions in the breast and prostate can progress to invasive cancers, that is, forms that begin to penetrate surrounding tissues.
Researchers have focused on two very common types of cancer: breast cancer and prostate cancer . Although they occur in different organs, these two diseases have some important similarities: both can be influenced by hormones, both occur in glandular tissues, and both can go through a precancerous stage before becoming invasive.
What does “precancer” mean?
A precancerous lesion is not the same as invasive cancer. It means that there are altered, abnormal cells, but that are still “held in place” by a natural tissue barrier.
In the breast, an example is ductal carcinoma in situ , abbreviated DCIS. This means that the abnormal cells are located inside the breast ducts, without having invaded the surrounding tissue.
In the prostate, a similar lesion is high-grade prostatic intraepithelial neoplasia , abbreviated HGPIN. This is considered a precancerous change in the prostate glands.
In short:
precancer is like a problem still “inside the fence” , and invasive cancer occurs when cells manage to cross this “fence” and penetrate the surrounding tissues.
What is the “fence” that holds cells in place?
Breast and prostate tissues have an organized structure. The cells are arranged in layers, and one of these layers functions as a protective barrier.
In precancerous stages, this barrier is usually still present. When cancer becomes invasive, the barrier breaks down or disappears, and abnormal cells can break out of their original area.
This transition from “cells held in place” to “cells that invade” is one of the most important stages in the development of cancer.
What did the researchers do differently in this study?
Typically, a tumor is examined under a microscope in very thin slices, like looking at a single page in a book. The problem is that a single slice doesn’t always tell the whole story.
In this study, the researchers used modern methods to analyze tissues in 3D , meaning in volume, not just on the surface. They combined advanced microscopic imaging with genetic analysis done directly in the tissue, to see where certain cells are located and which genes are active in those areas.
319 samples/spatial analyses from 51 breast cancer and prostate cancer cases were analyzed .
Why is 3D analysis important?
3D analysis has shown that areas that appear separate on a regular 2D image may actually be connected to each other deep within the tissue.
In other words, what may appear to be an isolated lesion on a microscope slide may be part of a larger, more complex structure. This information is important because it helps doctors and researchers better understand how cancer cells spread in tissue.
What did they discover in breast cancer?
In breast cancer, researchers have analyzed the transition from DCIS, a non-invasive form, to invasive breast cancer.
They observed that certain genes appear to be more active in precancerous areas and less active in invasive areas. Two of these genes are MGP and PLAT .
According to patients, these genes appear to help maintain normal tissue order and structure. When their activity decreases, cells may become more able to multiply and migrate.
In laboratory tests, reducing the activity of the MGP and PLAT genes in cells from DCIS lesions led to faster growth and greater cell migration.
What did they discover in prostate cancer?
In prostate cancer, researchers have tracked the progression from normal tissue and HGPIN to invasive forms of prostate cancer.
Several genes have been identified that become more active as the disease progresses to an invasive form, including GDF15 , ALDH1A3 , ANPEP , and FASN .
In laboratory experiments, when the activity of these genes was reduced in prostate cancer cells, the cells multiplied more slowly and moved more slowly.
This suggests that these genes may play a role in prostate cancer’s ability to grow and invade surrounding tissues.
What role does the immune system play?
The study showed that it’s not just the cancer cells that matter. The cells surrounding the tumor can also influence the course of the disease.
The researchers observed certain immune cells, called macrophages , near areas where the lesions were becoming more invasive. Macrophages are cells that normally help the body fight infections and clear damaged tissues.
In cancer, however, some macrophages can end up supporting the tumor, helping it grow or invade surrounding tissue.
The study identified two types of macrophages associated with different areas of the tumor, including macrophages marked by SPP1 and MS4A6A .
What role does the tissue around the tumor play?
The tumor does not live in isolation. It is surrounded by blood vessels, supporting fibers, immune cells, and other normal cells.
Researchers have observed that certain supporting cells, called cancer-associated fibroblasts , may be especially present near invasive areas. These cells can modify the “skeleton” of tissue around the tumor and create a more favorable environment for the cancer to spread.
MFAP5 and ASPN have been identified as being associated with these changes in the tissue surrounding the tumor.
What do these findings mean for patients?
This study does not immediately change standard treatment for breast cancer or prostate cancer. It is laboratory research and advanced tissue analysis, not a clinical guide to today’s treatment choices.
However, the results are important for the future because they can help to:
- better understanding how a precancer becomes invasive cancer;
- identifying possible markers that show which lesions have a higher risk of progression;
- developing treatments that block the progression to invasive disease;
- understanding the role of the immune system and the tissue surrounding the tumor in the evolution of cancer.
Is any precancerous lesion dangerous?
Not all precancerous lesions automatically progress to invasive cancer. Some may remain stable for a long time, while others may progress.
That is why doctors carefully monitor these lesions and make decisions based on the type of change, biopsy results, patient age, medical history, risk factors, and recommendations from medical guidelines.
What should the patient remember?
The most important message is this:
cancer does not appear all at once, but often goes through several biological stages .
In breast cancer and prostate cancer, researchers have observed that the transition from precancer to invasive cancer is linked to the breakdown of a natural tissue barrier, genetic changes in cells, and the influence of the environment surrounding the tumor.
These findings may help, in the future, with more accurate diagnosis and better targeted treatments.
Conclusion
The study shows that to understand cancer, it’s not enough to just look at cancer cells in isolation. We need to see where they are , how they are connected , what genes they use , and how they interact with the cells around them .
3D analysis of tumors provides a more complete picture of the transition from precancerous lesions to invasive cancer in the breast and prostate. For patients, this research brings hope for better methods of prevention, monitoring and treatment in the future.
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Dr. Onisim Florin Senior Medical Oncologist