Grade of Ductal Carcinoma In Situ Accompanying Infiltrating Ductal Carcinoma As an Independent Prognostic Factor

Kim, Ju Yeon; Han, Wonshik; Moon, Hyeong‐Gon; Park, In Ae; Ahn, Seung-Ho; Kim, Jisun; Lee, Jun Woo; Kim, Taeryung; Kim, Min Kyoon; Noh, Dong Young

doi:10.1016/j.clbc.2013.04.005

Cited by 17 publications

(22 citation statements)

References 23 publications

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“…To the best of our knowledge, the link between this finding and breast cancer prognosis is unclear. Although some studies have suggested that the presence of DCIS or LCIS with an invasive tumor either has no effect on disease recurrence or is a predictor of good prognosis, other studies have suggested recurrence‐free survival may be lower if there is extensive DCIS within surrounding normal tissue or the DCIS is of high grade . We were unable to evaluate the grade of the in situ component or in situ extent in the current study.…”

Section: Discussionmentioning

confidence: 74%

“…Cancer DCIS or LCIS with an invasive tumor either has no effect on disease recurrence or is a predictor of good prognosis, [30][31][32][33] other studies have suggested recurrence-free survival may be lower if there is extensive DCIS within surrounding normal tissue or the DCIS is of high grade. 34,35 We were unable to evaluate the grade of the in situ component or in situ extent in the current study. Data addressing the impact of these factors are needed to clarify the contributions of calcifications with in situ components to the prognosis of women with invasive breast cancer.…”

Section: Breast Calcifications and Tumor Features/nyante Et Almentioning

confidence: 99%

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The association between mammographic calcifications and breast cancer prognostic factors in a population‐based registry cohort

Nyante

Lee

Benefield

et al. 2016

Cancer

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Background Mammographic calcifications can be a marker of malignancy, but their association with prognosis is less well-established. We examined the relationship between calcifications and breast cancer prognostic factors in the population-based Carolina Mammography Registry (CMR). Methods This study included 8,472 invasive breast cancers diagnosed in the CMR between 1996-2011 where information regarding calcifications occurring within two years of diagnosis was reported. Calcification-specific Breast Imaging-Reporting and Data System (BI-RADS) assessments were reported prospectively by a radiologist. Tumor characteristic data were obtained from the North Carolina Central Cancer Registry and/or pathology reports. Multivariable-adjusted associations between the presence of calcifications in the breast affected by cancer and tumor characteristics were estimated using logistic regression. Statistical tests were two-sided. Results The presence of calcifications was positively associated with tumors that were high grade (vs. low, odds ratio (OR)=1.43, 95% confidence interval (CI) 1.10-1.88) or had an in situ component (vs. without, OR=2.15, 95%CI 1.81-2.55). Calcifications were inversely associated with hormone receptor-negative (vs. positive, OR=0.73, 95%CI 0.57-0.93), >35mm (vs. ≤8mm, OR=0.47, 95%CI 0.37-0.61), and lobular (vs. ductal, OR=0.39, 95%CI 0.22-0.69) tumors. The association between the presence of calcifications and an in situ component was limited to BI-RADS 4 and 5 calcifications and was absent for BI-RADS 2 or 3 (P-heterogeneity<0.01). The association with tumor size was strongest for BI-RADS 3 and 4 (P-heterogeneity<0.01). Conclusion Calcifications were associated with both unfavorable (high grade) and favorable (small size, hormone receptor-positive) prognostic factors. Detailed analysis of calcification biological features is necessary to understand the mechanisms driving these associations.

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Section: Discussionmentioning

confidence: 74%

Section: Breast Calcifications and Tumor Features/nyante Et Almentioning

confidence: 99%

The association between mammographic calcifications and breast cancer prognostic factors in a population‐based registry cohort

Nyante

Lee

Benefield

et al. 2016

Cancer

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“…3 As predicted by Kim et al, grade of DCIS in synchronous IDC-DCIS doesn't predict recurrence. 4 High-grade lesions were equally distributed in both recurrent and non-recurrent groups. However, high-grade lesions parse were very high in our study, which can be responsible for high rates of recurrence in the current study despite of the lesions being in early stage and the difference not being made out in our study could be because of the less number.…”

Section: Discussionmentioning

confidence: 97%

Clinical Relevance of Coexistence of Ductal Ca in Situ and Invasive Ductal Carcinoma of Breast

Ramalingam¹,

Krishnamurthy²

2017

jebmh

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BACKGROUNDThere are many studies reported in the literature with respect to the Ductal Carcinoma in Situ (DCIS) progressing into Invasive Ductal Carcinoma (IDC) of the breast. However, there is hardly any study on the coexistence of both and its clinical significance. The aim of the study is to analyse the clinical and pathological parameters of synchronous DCIS and IDC to predict the prognostic factors. MATERIALS AND METHODS42 patients with a final pathological diagnosis of synchronous DCIS and IDC diagnosed in 2009-11 were included in the study. Statistical analysis was done using SPSS software utilising the appropriate analytical methods. RESULTSMajority of the patients in this study group presented with early breast cancer (64.3%). Forty eight percent were Her2 subtype (ER, PR negative and HER2/neu-positive) and 31% were triple negative. Eighty one percent of the IDC associated histology was Not Otherwise Specified (NOS) type. Grade 3 lesions were more common (57%). Recurrence of the disease occurred in 66% of patients during a mean duration of follow up of 3.6 years with predominance of visceral metastasis (51.5%). Recurrence was more common in node positive disease (59.5%), those with lymphovascular emboli (59.5%) and perinodal spread (76%) on histopathological examination. CONCLUSIONSynchronous DCIS and IDC disease entity appears to have an aggressive nature compared to the course of IDC alone entity. Prognostic factors relating to IDC appears to correlate well with recurrence than that of the prognostic factors of DCIS component in such synchronous setting.

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“…Previous evidence suggests that IDC with accompanying DCIS may represent a distinct clinical and biological entity from pure IDC [6]. Pure invasive carcinoma, in comparison to mixed invasive carcinoma with DCIS, are larger, higher grade, have higher Ki-67 expression, fewer calcifications, and are more frequently negative for expression of estrogen receptor (ER) and human epidermal growth receptor 2 (HER2) [6-12]. Castro and colleagues found a substantial number of differentially expressed genes in pure DCIS compared with those expressed in mixed IDC/DCIS [13] and some studies suggest that the presence of a DCIS component is associated with cell-mediated immune changes in the microenvironment and neoplastic epithelial cells surrounding the DCIS leading to differences in tumor progression and improved prognosis [6, 9-10, 14-16].…”

Section: Introductionmentioning

confidence: 99%

Breast cancer risk factor associations differ for pure versus invasive carcinoma with an in situ component in case–control and case–case analyses

Ruszczyk

Zirpoli

Kumar

et al. 2015

Cancer Causes Control

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Purpose Invasive ductal carcinoma (IDC) is diagnosed with or without a ductal carcinoma in situ (DCIS) component. Previous analyses have found significant differences in tumor characteristics between pure IDC lacking DCIS and mixed IDC with DCIS. We will test our hypothesis that pure IDC represents a form of breast cancer with etiology and risk factors distinct from mixed IDC/DCIS. Methods We compared reproductive risk factors for breast cancer risk, as well as family and smoking history between 831 women with mixed IDC/DCIS (n=650) or pure IDC (n=181), and 1,620 controls, in the context of the Women's Circle of Health Study (WCHS), a case-control study of breast cancer in African-American and European-American women. Data on reproductive and lifestyle factors were collected during interviews, and tumor characteristics were abstracted from pathology reports. Case-control and case-case analyses were conducted using unconditional logistic regression. Results Most risk factors were similarly associated with pure IDC and mixed IDC/DCIS. However, among postmenopausal women, risk for pure IDC was lower in women with body mass index (BMI) 25 to <30 kg/m2 (Odds Ratio (OR)=0.66; 95% confidence interval (CI), 0.35-1.23) and BMI≥30 kg/m2 (OR=0.33; 95% CI, 0.18-0.67) compared to women with BMI<25 kg/m2, with no associations with mixed IDC/DCIS. In case-case analyses, women who breastfed up to 12 months (OR=0.55; 95% CI, 0.32-0.94) or longer (OR=0.47; 95% CI, 0.26-0.87) showed decreased odds of pure IDC than mixed IDC/DCIS compared to those who did not breastfeed. Conclusions Associations with some breast cancer risk factors differed between mixed IDC/DCIS and pure IDC, potentially suggesting differential developmental pathways. These findings, if confirmed in a larger study, will provide a better understanding of the development patterns of breast cancer and the influence of modifiable risk factors, which in turn could lead to better preventive measures for pure IDC, which have worse disease prognosis compared to mixed IDC/DCIS.

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Grade of Ductal Carcinoma In Situ Accompanying Infiltrating Ductal Carcinoma As an Independent Prognostic Factor

Cited by 17 publications

References 23 publications

The association between mammographic calcifications and breast cancer prognostic factors in a population‐based registry cohort

The association between mammographic calcifications and breast cancer prognostic factors in a population‐based registry cohort

Clinical Relevance of Coexistence of Ductal Ca in Situ and Invasive Ductal Carcinoma of Breast

Breast cancer risk factor associations differ for pure versus invasive carcinoma with an in situ component in case–control and case–case analyses

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