Breast ductal carcinoma in situ with microinvasion

Mascarel, Isabelle de; MacGrogan, Gaëtan; Mathoulin‐Pélissier, Simone; Soubeyran, Isabelle; Picot, V.; Coindre, Jean‐Michel

doi:10.1002/cncr.10451

Cited by 101 publications

(34 citation statements)

References 34 publications

(40 reference statements)

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“…This observation is provocative in that it provides an apparent link between tumor stage and tumor grade. Support for this finding is provided by the clinical observation that poorly differentiated (grade III) DCIS is more likely to be associated with occult invasive disease than its well-differentiated (grade I) counterparts (21). Therefore, our data suggest that the transcriptional program that drives cancer cells to an advanced tumor grade may also confer invasiveness.…”

Section: Discussionsupporting

confidence: 68%

Gene expression profiles of human breast cancer progression

Salunga

Tuggle

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

793

654

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Although distinct pathological stages of breast cancer have been described, the molecular differences among these stages are largely unknown. Here, through the combined use of laser capture microdissection and DNA microarrays, we have generated in situ gene expression profiles of the premalignant, preinvasive, and invasive stages of human breast cancer. Our data reveal extensive similarities at the transcriptome level among the distinct stages of progression and suggest that gene expression alterations conferring the potential for invasive growth are already present in the preinvasive stages. In contrast to tumor stage, different tumor grades are associated with distinct gene expression signatures. Furthermore, a subset of genes associated with high tumor grade is quantitatively correlated with the transition from preinvasive to invasive growth.

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Section: Discussionsupporting

confidence: 68%

Gene expression profiles of human breast cancer progression

Salunga

Tuggle

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

793

654

View full text Add to dashboard Cite

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“…But various patterns in DCIS may be mis-interpreted as stromal invasion, including the cases where there is degenerative appearance of the dislodged tumour cells, chronic inflammatory reaction, crush artefacts, cautery effects, and distortion or entrapment of involved ducts or acini by fibrosis [6-8,20]. As reported earlier [4], it is difficult to determine whether in-situ breast carcinoma is associated with microinvasion, even with the help of immunohistochemistry techniques.…”

Section: Discussionmentioning

confidence: 99%

Expression and role of fibroblast activation protein-alpha in microinvasive breast carcinoma

Hua

Huang

et al. 2011

Diagn Pathol

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BackgroundDiagnosis of ductal carcinoma in situ (DCIS) in breast cancer cases is challenging for pathologist due to a variety of in situ patterns and artefacts, which could be misinterpreted as stromal invasion. Microinvasion is detected by the presence of cytologically malignant cells outside the confines of the basement membrane and myoepithelium. When malignant cells invade the stroma, there is tissue remodeling induced by perturbed stromal-epithelial interactions. Carcinoma-associated fibroblasts (CAFs) are main cells in the microenvironment of the remodeled tumor-host interface. They are characterized by the expression of the specific fibroblast activation protein-alpha (FAP-α), and differ from that of normal fibroblasts exhibiting an immunophenotype of CD34. We hypothesized that staining for FAP-α may be helpful in determining whether DCIS has microinvasion.Methods349 excised breast specimens were immunostained for smooth muscle actin SMA, CD34, FAP-α, and Calponin. Study material was divided into 5 groups: group 1: normal mammary tissues of healthy women after plastic surgery; group 2: usual ductal hyperplasia (UDH); group 3: DCIS without microinvasion on H & E stain; group 4: DCIS with microinvasion on H & E stain (DCIS-MI), and group 5: invasive ductal carcinoma (IDC). A comparative evaluation of the four immunostains was conducted.ResultsOur results demonstrated that using FAP-α and Calponin adjunctively improved the sensitivity of pathological diagnosis of DCIS-MI by 11.29%, whereas the adjunctive use of FAP-α and Calponin improved the sensitivity of pathological diagnosis of DCIS by 13.6%.ConclusionsThis study provides the first evidence that immunostaining with FAP-α and Calponin can serve as a novel marker for pathologically diagnosing whether DCIS has microinvasion.

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“…All female patients with a primary invasive breast cancer and treated with BCS in a regional comprehensive cancer center (South-West France) from 1990 to 1994 and followed up to January 2006 (n = 1015) were prospectively included in a clinical and pathological database [13,14]. Follow-up included a routine quarterly visit for 2 years, every 6 months for the next 4 years and annually thereafter [13].…”

Section: Methodsmentioning

confidence: 99%

Separate and combined analysis of successive dependent outcomes after breast-conservation surgery: recurrence, metastases, second cancer and death

et al. 2010

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BackgroundIn the setting of recurrent events, research studies commonly count only the first occurrence of an outcome in a subject. However this approach does not correctly reflect the natural history of the disease. The objective is to jointly identify prognostic factors associated with locoregional recurrences (LRR), contralateral breast cancer, distant metastases (DM), other primary cancer than breast and breast cancer death and to evaluate the correlation between these events.MethodsPatients (n = 919) with a primary invasive breast cancer and treated in a cancer center in South-Western France with breast-conserving surgery from 1990 to 1994 and followed up to January 2006 were included. Several types of non-independent events could be observed for the same patient: a LRR, a contralateral breast cancer, DM, other primary cancer than breast and breast cancer death. Data were analyzed separately and together using a random-effects survival model.ResultsLRR represent the most frequent type of first failure (14.6%). The risk of any event is higher for young women (less than 40 years old) and in the first 10 years of follow-up after the surgery. In the combined analysis histological tumor size, grade, number of positive nodes, progesterone receptor status and treatment combination are prognostic factors of any event. The results show a significant dependence between these events with a successively increasing risk of a new event after the first and second event. The risk of developing a new failure is greatly increased (RR = 4.25; 95%CI: 2.51-7.21) after developing a LRR, but also after developing DM (RR = 3.94; 95%CI: 2.23-6.96) as compared to patients who did not develop a first event.ConclusionWe illustrated that the random effects survival model is a more satisfactory method to evaluate the natural history of a disease with multiple type of events.

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Breast ductal carcinoma in situ with microinvasion

Cited by 101 publications

References 34 publications

Gene expression profiles of human breast cancer progression

Gene expression profiles of human breast cancer progression

Expression and role of fibroblast activation protein-alpha in microinvasive breast carcinoma

Separate and combined analysis of successive dependent outcomes after breast-conservation surgery: recurrence, metastases, second cancer and death

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