Expression of HER2neu in Ductal Carcinoma in situ is Associated with Local Recurrence

Han, Kathy; Nofech‐Mozes, Sharon; Narod, Steven A.; Hanna, Wedad; Vesprini, Danny; Saskin, Refik; Taylor, C.W.; Kong, Iwa; Paszat, Lawrence; Rakovitch, Eileen

doi:10.1016/j.clon.2011.09.008

Cited by 53 publications

(50 citation statements)

References 23 publications

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“…In a second study, we showed that for Luminal B (HER2 positive/ER positive) and HER2-like (HER2ϩve/ER-ve) DCIS, HER2 expression determined by IHC/FISH was associated with an increased risk of recurrence (56 ). This was consistent with an earlier study from our group (59 ) and with earlier studies by Provenzano (65 ), Kepple (66 ), Holmes (67 ) (42,57 )].…”

Section: Molecular Progression Of Dcis-through a Glass Darklysupporting

confidence: 82%

Ductal Carcinoma In Situ of the Breast: Can Biomarkers Improve Current Management?

2014

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BACKGROUND:Screening for invasive cancer has led to a marked increase in the detection of ductal carcinoma in situ (DCIS). DCIS is, if appropriately managed, a low-risk disease which has a small chance of impacting on patient life expectancy. However, despite significant advances in prognostic marker development in invasive breast cancer, there are no validated diagnostic assays to inform treatment choice for women with DCIS. Therefore we are unable to target effective treatment strategies to women at high risk and avoid overtreatment of women at low risk of progression to invasive breast cancer. Paradoxically, one effect of this uncertainty is undertreatment of some women.CONTENT: We review current practice and research in the field to identify key challenges in the management of DCIS. The impact of clinical research, particularly on the over and undertreatment of women with DCIS is assessed. We note slow progress toward development of diagnostic biomarkers and highlight key opportunities to accelerate advances in this area.SUMMARY: DCIS is a low-risk disease, its incidence is increasing, and current treatment is effective. However, many women are either over-or undertreated. Despite repeated calls for development of diagnostic biomarkers, progress in this area has been slow, reflecting a relative lack of investment of research effort and funding. Given the low event rate in treated patients and the lateness of recurrences, many previous studies have only limited power to identify independent prognostic and predictive biomarkers. However, the potential for such biomarkers to personalize treatment for DCIS is extremely high.

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Section: Molecular Progression Of Dcis-through a Glass Darklysupporting

confidence: 82%

Ductal Carcinoma In Situ of the Breast: Can Biomarkers Improve Current Management?

2014

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“…High grade and large size has been shown to be of some prognostic relevance for local recurrence (EBCTCG) but we lack factors that predict risk for developing invasive cancer. In invasive cancer, molecular subtype has been shown to predict prognosis (Su [14], Normanno [15]) but very little data has been published regarding DCIS [10,16]. There are no publications using the proposed criteria from St Gallen, 2011(Goldhirsch, [1]) in DCIS.…”

Section: Discussionmentioning

confidence: 99%

Molecular subtypes in ductal carcinoma in situ of the breast and their relation to prognosis: a population-based cohort study

et al. 2013

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BackgroundDifferent molecular subtypes of breast cancer have been identified based on gene expression profiling. Treatment suggestions based on an approximation of these subtypes by immunohistochemical criteria have been published by the St Gallen international expert consensus panel. Ductal carcinoma in situ (DCIS) can be classified into the same molecular subtypes. Our aim was to study the relation between these newly defined subtypes and prognosis in DCIS.MethodsTMA including 458 women from a population-based cohort with DCIS diagnosed 1986–2004 was used. Stainings for ER, PR, HER2 and Ki67 were used to classify the surrogate molecular subtypes according to the St Gallen criteria from 2011. The associations with prognosis were examined using Kaplan-Meier analyses and Cox proportional hazards regression models.ResultsSurrogate molecular subtyping could be done in 381 cases. Mean follow up was 164 months. Of the classified DCIS 186 were Luminal A (48.8%), 33 Luminal B/HER2- (8.7%), 74 Luminal B/HER2+ (17.4%), 61 HER2+/ER- (16.0%) and 27 Triple Negative (7.1%). One hundred and two women had a local recurrence of which 58 were invasive. Twenty-two women had generalised disease, 8 without a prior local recurrence. We could not find a prognostic significance of the molecular subtypes other than a higher risk of developing breast cancer after more than 10 years of follow-up among women with a Triple Negative DCIS (OR 3.2; 95% CI 1.1-9.8).ConclusionsThe results from this large population-based cohort, with long-term follow up failed to demonstrate a prognostic value for the surrogate molecular subtyping of DCIS using the St Gallen criteria up to ten years after diagnosis. More than ten years after diagnosis Triple Negative DCIS had an elevated risk of recurrence.

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“…Kürzlich publizierte Daten bewerten eine HER2-Überexpression als signifikanten Prädiktor für das invasive Potential eines DCIS [12,24]. Falls der HER2-Status ein Prädiktor für das Auftreten oder Vorhandensein von invasiven-Läsionen beim DCIS sein sollte, wäre der frühzei-tige Einsatz einer HER2-gerichteten Therapie durchaus denkbar.…”

Section: Her2-gerichtete Therapieunclassified

Behandlung des duktalen Carcinoma in situ

et al. 2012

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Behandlung des duktalen Carcinoma in situDurch Einführung des Mammographiescreenings hat die Diagnostik von Mikrokalzifikationen in den letzten Jahren zugenommen, und infolge der häufigeren Untersuchungen hat sich auch die Inzidenz des duktalen Carcinoma in situ (DCIS) deutlich erhöht. Mehr als 85% der DCIS werden mammographisch entdeckt. In Län-dern, die wie Deutschland ein bevöl-kerungsbezogenes Mammographiescreening durchführen, macht das DCIS heute etwa 20−25% der neu diagnostizierten Mammakarzinome aus, während der Anteil vor Einführung des Screenings bei etwa 3−5% lag. Aufgrund der um mehr als das 10-Fache gestiegenen Inzidenz muss sich der senologisch tätige Gynäkologe auch mehr als früher mit der Therapie des DCIS auseinandersetzen.

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Expression of HER2neu in Ductal Carcinoma in situ is Associated with Local Recurrence

Cited by 53 publications

References 23 publications

Ductal Carcinoma In Situ of the Breast: Can Biomarkers Improve Current Management?

Ductal Carcinoma In Situ of the Breast: Can Biomarkers Improve Current Management?

Molecular subtypes in ductal carcinoma in situ of the breast and their relation to prognosis: a population-based cohort study

Behandlung des duktalen Carcinoma in situ

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