Duct carcinoma in situ: 227 cases without microinvasion

Silverstein, Melvin J.; Cohlan, Bernard F.; Gierson, Eugene D.; Furmanski, Martin; Gamagami, Parvis; Colburn, William J.; Lewinsky, Bernard S.; Waisman, James

doi:10.1016/s0959-8049(05)80114-5

Cited by 138 publications

(46 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Fisher et al 31 defined multifocality of in situ carcinoma as the presence of in situ tumor in 2 different tissue blocks from the same case (shown in 60.8% of their cases). Silverstein et al 32 considered in situ carcinomas to be multifocal when separate in situ foci were found > 2 cm from the primary site (found in 41% of cases). Faverly et al 33 demonstrated discontinuity of in situ tumor cell proliferation in 3-dimensional thick-section images assessed with a stereoscopic microscope.…”

Section: Discussionmentioning

confidence: 99%

Clinical relevance of the distribution of the lesions in 500 consecutive breast cancer cases documented in large‐format histologic sections

Tot

2007

Cancer

107

View full text Add to dashboard Cite

We investigated whether AMP‐activated protein kinase (AMPK), a multi‐functional regulator of energy homeostasis, participates in the regulation of erythropoietin (EPO)‐mediated activation of endothelial nitric oxide synthase (eNOS) in endothelial cells (ECs) and mice. In ECs, treatment with EPO increased the phosphorylation of AMPK, acetyl‐CoA carboxylase (ACC), and eNOS, as revealed by Western blot analysis. Inhibition of AMPK activation by compound C or dominant‐negative AMPK mutant abrogated the EPO‐induced increase in the phosphorylation of AMPK, ACC, and eNOS, as well as nitric oxide (NO) production. Additionally, suppression of AMPK activation abolished EPO‐induced EC proliferation, migration and tube formation. Immunoprecipitation analysis demonstrated that AMPK mediated the EPO‐induced increase in the phosphorylation of β common receptor (βCR) and the formation of a βCR–AMPK–eNOS complex. In mice, inhibition of AMPK activation by compound C markedly decreased EPO‐elicited angiogenesis in Matrigel plugs. Furthermore, the phosphorylation of AMPK and eNOS was significantly higher in aortas from EPO transgenic mice than wild‐type mice. Moreover, treatment with EPO neutralizing antibody greatly reduced the exercise training‐induced increase in phosphorylation of AMPK and eNOS in aortas of wild‐type mice. Taken together, EPO may trigger AMPK‐dependent signaling, which leads to enhanced phosphorylation of βCR and eNOS, increased βCR–AMPK–eNOS complex formation, NO production, and, ultimately, angiogenesis. J. Cell. Physiol. 227: 3053–3062, 2012. © 2011 Wiley Periodicals, Inc.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical relevance of the distribution of the lesions in 500 consecutive breast cancer cases documented in large‐format histologic sections

Tot

2007

Cancer

107

View full text Add to dashboard Cite

show abstract

“…The main problem with breast conservation is local recurrence. After planned local excision of DCIS, without post-operative radiotherapy, various recurrence rates have been reported: 8% after a median follow up of 18 months (Silverstein et al, 1992), 15% at 4 years (Lagios et al, 1982), 23% at 39 months (Fisher et al, 1986), 55% at 7 years (Price et al, 1989), 63% at 9 years (Price et al, 1990). The number of local recurrences increases with time; Fisher's recurrence rate of 23% at 39 months increased to 43% at 83 months (Fisher et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

The importance of complete excision in the prevention of local recurrence of ductal carcinoma in situ

Holland¹,

Gandhi²,

Knox³

et al. 1998

Br J Cancer

View full text Add to dashboard Cite

Summary Mastectomy probably represents over-treatment for the majority of women with screen detected ductal carcinoma in situ (DCIS) and breast-conserving surgery is now widely advocated. In this study, biopsy cavity shavings were used to ensure Ductal carcinoma in situ (DCIS) has become clinically important only since the advent of routine high-quality mammography, and now accounts for 20-25% of screen-detected breast malignancies (Verbeek et al, 1984). The majority of screen detected DCIS lesions, however, are asymptomatic and impalpable (Gump et al, 1987).Despite the increase in diagnosis, the optimal surgical treatment for DCIS remains controversial. Until recently, DCIS was not differentiated from invasive breast carcinoma and was treated by mastectomy (Price et al, 1989). Since the widespread acceptance of breast-conserving surgery for early invasive breast cancer however, mastectomy is becoming more difficult to justify for localized screen-detected DCIS The main purpose of breast-conserving surgery for invasive or in situ disease is complete excision of the tumour (both macroscopically and microscopically) with a surrounding margin of normal tissue to prevent local recurrence, while maintaining a cosmetically acceptable breast. Unfortunately, there is no regular consensus regarding the definition of complete excision or of an adequate margin of excision. It is clear that the margin of clearance around an invasive tumour correlates with local control rates, with positive resection margins being associated with an increased risk of local recurrence (Veronesi et al, 1990). However, the volume of excised tissue is inversely proportional to the cosmetic outcome (Wazer et al, 1992 (Price et al, 1989).Inadequate excision of the primary lesion appears to be one of the most important causes of local failure after breast-conserving surgery (Silverstein et al, 1994), and new prognostic index for DCIS has been proposed recently that includes resection margins as one of its predictive factors (Silverstein et al, 1996). The Van Nuys prognostic index (VNPI) also quantifies two other predictors of local recurrence, namely DCIS size and pathological classification. A numerical system is used to predict patients more likely to recur after breast conserving surgery.The histological evaluation of excision margins is now known to be a critical part of the assessment of any patient with DCIS being considered for breast-conserving treatment, and various techniques have been used to improve the accuracy, including inking of specimen margins, two-dimensional radiography, cavity shavings and tumour bed biopsies. Biopsy cavity shavings are routinely used in our unit after wide local excision of invasive carcinomas to reduce the incidence of re-excision in patients with the tumour extending close to the main specimen margin.The aim of this study was to determine the effectiveness of using biopsy cavity shavings to ensure complete excision of screen-detected DCIS lesions. PATIENTS AND METHODSScreening mammography is performed at...

show abstract

“…The main goal of surgical treatment for women with DIN is breast conserving surgery (BCS) [18][19][20] particularly for those patients with small solid masses, mammographically-detected lesions, or limited microcalcification areas, and because it is a disease with an extremely high survival rate and low absolute risk of LR.…”

Section: Surgical Treatmentmentioning

confidence: 99%

The management of ductal intraepithelial neoplasia (DIN): open controversies and guidelines of the Istituto Europeo di Oncologia (IEO), Milan, Italy

Farante

Zurrida

Galimberti

et al. 2010

Breast Cancer Res Treat

View full text Add to dashboard Cite

show abstract

Duct carcinoma in situ: 227 cases without microinvasion

Cited by 138 publications

References 22 publications

Clinical relevance of the distribution of the lesions in 500 consecutive breast cancer cases documented in large‐format histologic sections

Clinical relevance of the distribution of the lesions in 500 consecutive breast cancer cases documented in large‐format histologic sections

The importance of complete excision in the prevention of local recurrence of ductal carcinoma in situ

The management of ductal intraepithelial neoplasia (DIN): open controversies and guidelines of the Istituto Europeo di Oncologia (IEO), Milan, Italy

Contact Info

Product

Resources

About