Identifying recurrences and metastasis after ductal carcinoma in situ (DCIS) of the breast

Abstract

Identifying recurrences and metastasis after ductal carcinoma in situ (DCIS) of the breast Ductal carcinoma in situ (DCIS) of the breast is a non-invasive tumour that has the potential to progress to invasive ductal carcinoma (IDC). Thus, it represents a treatment dilemma: alone it does not present a risk to life, however, left untreated it may progress to a life-threatening condition. Current clinico-pathological features cannot accurately predict which patients with DCIS have invasive potential, and therefore clinicians are unable to quantify the risk of progression for an individual patient. This leads to many women being over-treated, while others may not receive sufficient treatment to prevent invasive recurrence. A better understanding of the molecular features of DCIS, both tumour-intrinsic and the microenvironment, could offer the ability to better predict which women need aggressive treatment, and which can avoid therapies carrying significant sideeffects and such as radiotherapy. In this review, we summarise the current knowledge of DCIS, and consider future research directions.

Transcriptome analysis reveals differences in cell cycle, growth and migration related genes that distinguish fibroblasts derived from pre-invasive and invasive breast cancer

“…Previous studies have indicated that ER expression in DCIS is associated with disease recurrence ( 7 , 8 ). Here, we found that DCIS fibroblasts enhanced DCIS.com growth and invasion in vivo .…”

“…For IDC fibroblasts, we considered molecular subtype and disease stage as potential factors for their heterogeneity. The effects of molecular subtype in gene expression have previously been documented ( 7 , 42 – 44 ). By PCA, fibroblasts that originated from triple negative IDC, such as 8661 and 2760 grouped more closely together than fibroblasts 8870 and 8727, which originated from ER+/PR/HER2+ IDC tissues.…”

“…There are currently no reliable approaches to determine which cases of DCIS will progress to invasive disease. Low grade or small DCIS lesions may still become invasive (5)(6)(7). Moreover, some biomarkers such as Estrogen receptor (ER), HER2, Ki67, p16, and Cox2 are associated with disease recurrence but not progressive invasion (7,8).…”

“…Low grade or small DCIS lesions may still become invasive (5)(6)(7). Moreover, some biomarkers such as Estrogen receptor (ER), HER2, Ki67, p16, and Cox2 are associated with disease recurrence but not progressive invasion (7,8). By understanding the molecular and cellular processes associated with DCIS to IDC progression, we can identify new biomarkers to determine which cases of DCIS are more likely to progress to invasion and improve treatment of DCIS for patients.Fibroblasts are a major cellular component in the breast tumor microenvironment.…”

Annual Review Issue: Breast Pathology

“…Professor Stephen Fox and his colleagues summarise the current knowledge of ductal carcinoma in situ (DCIS) and discuss in depth the relevant prognostic clinic‐pathological features to predict which types of DCIS have invasive potential, hence quantifying the risk of progression for individual patients who can avoid potential over‐ or under‐ treatment 9 . Future research directions are also highlighted.…”