Impact of hormonal status on outcome of ductal carcinoma in situ treated with breast-conserving surgery plus radiotherapy: Long-term experience from two large-institutional series

Meattini, Icro; Saieva, Calogero; Bastiani, P.; Martella, Francesca; Russo, Monica Lo; Paoletti, L.; Doria, Morena; Desideri, Isacco; Terziani, Francesca; Cardillo, Carla De Luca; Bendinelli, Benedetta; Ciabatti, C.; Muntoni, Cristina; Tinacci, Galliano; Nori, Jacopo; Smith, Herd; Brancato, Beniamino; Galli, Lorenzo; Sanchez, Luis; Casella, Donato; Bernini, Marco; Orzalesi, Lorenzo; Carta, G; Bianchi, Simonetta; Rossi, Francesca; Livi, Lorenzo

doi:10.1016/j.breast.2017.03.017

Cited by 9 publications

(10 citation statements)

References 32 publications

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“…Nonetheless, the hormonal status of DCIS is independently associated with the time of overall survival of the patient ( P < .05), with a lower relative risk of mortality in patients with positive HS DCIS. These findings are in agreement with the known correlation between breast cancer increasing mortality and HS . It is known that ER/PR positivity in both DCIS and invasive breast cancer correlates with a favorable prognosis, as these tumors follow a low‐grade trajectory and tend to exhibit well‐differentiated morphology even with a high nuclear grade .…”

Section: Discussionsupporting

confidence: 91%

“…In concordance with previous studies, a positive and close margin is associated with an increased risk of local recurrence and overall survival . This well‐recognized risk factor is due to the increased risk of residual tumor with a closer positive margin and is therefore important to achieve safe oncological margins surgically.…”

Section: Discussionsupporting

confidence: 87%

“…However, the role of molecular subtyping on the prognosis and treatment on DCIS is less well understood . A recent study from Italy suggests that a negative ER status and a negative hormonal status (HS) are associated with a higher rate of local regional recurrence …”

Section: Introductionmentioning

confidence: 99%

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Impact of hormonal status on ductal carcinoma in situ of the breast: Outcome and prognostic factors

Tay

Ong

et al. 2019

Breast J

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Breast J. 2020;26:937-945. wileyonlinelibrary.com/journal/tbj | 937 Abstract Ductal carcinoma in situ (DCIS) of the breast is a heterogeneous disease which is increasingly diagnosed through improved screening measures. Multiple prognostic scores have been devised to predict the risk of local recurrence (LR), and the optimal adjuvant management for DCIS is still debated. Hence, the aim of this analysis is to investigate the factors contributing to the prognosis of DCIS, in particular the role of its hormonal status. From 2005 to 2016, a total of 1221 female patients diagnosed with DCIS at the National Cancer Centre Singapore and Singapore General Hospital were studied. The mean age of diagnosis was 54 years of age (sd = 11.0), with estrogen receptor (ER)-positive DCIS tumors presenting earlier (mean age 54 vs 57 years of age; P < .001). DCIS with negative hormonal status (HS) correlates significantly with a larger size (mean 23.5mm vs 13.0 mm, P < .001) and higher grade of tumor (P < .001). Patients with positive HS were more likely to undergo breast conservation surgery over a mastectomy, in contrast to patients with negative HS (P < .001). Patients with negative HS had a poorer prognosis, with a shorter time of overall survival time (HR = 26.3, P = .020). In conclusion, our study shows that the hormonal status, age of diagnosis, and positive margins are important prognostic factors for DCIS, at least in our Asian population.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 87%

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Impact of hormonal status on ductal carcinoma in situ of the breast: Outcome and prognostic factors

Tay

Ong

et al. 2019

Breast J

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“…Radiotherapy is an important procedure in the comprehensive treatment of breast cancer, it helps to reduce the frequency of distant metastasis and the mortality rate by blocking the local recurrence of breast cancer [2–4]. Many studies have shown that the local recurrence rate of triple-negative breast cancer (TNBC) is significantly higher than that of estrogen receptor (ER)-positive breast cancer [5], and negative ER status of breast cancer negatively influenced local recurrence rates [6], potentially owing to the different biological characteristics of these types of cancer cells. However, radiation resistance of TNBC may results in higher local recurrence rates.…”

Section: Introductionmentioning

confidence: 99%

Estrogen Receptor Mediates the Radiosensitivity of Triple-Negative Breast Cancer Cells

Chen

Zhou

et al. 2017

Med Sci Monit

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BackgroundThis study aimed to evaluate differences in the radiosensitivities of triple-negative breast cancer (TNBC) and luminal-type breast cancer cells and to investigate the effects of estrogen receptor (ER) expression on the biological behaviors of the cells.Material/MethodsColony-forming assays were performed to detect differences in radiosensitivities in breast cancer cell lines. Gene transfection technology was used to introduce the expression of ERα in TNBC cells to compare the difference in radiosensitivity between the TNBC cells and ERα transfected cells. CCK-8 assays were used to observe changes in the proliferation of TNBC cells after ERα transfection. Immunofluorescence was used to detect the number of γH2AX foci in nuclei. Flow cytometry was used to detect changes in cell cycle distribution and apoptosis. Western blotting was used to detect changes in autophagy-associated proteins.ResultsThe radioresistance of the TNBC cell line MDA-MB-231 (231 cells) was greater than that of ERα-positive luminal-type breast cancer cell line MCF-7. Moreover, 231 cell proliferation and radioresistance decreased after ERα transfection. Interestingly, ERα-transfected 231 cells showed increased double-stranded breaks and delayed repair compared with 231 cells, and ERα-transfected 231 cells showed increased G2/M phase arrest and apoptosis after irradiation compared with those in 231 cells. ERα transfection in 231 cells reduced autophagy-related protein expression, suggesting that autophagy activity decreased in 231 ER-positive cells after irradiation.ConclusionsTNBC cells were more resistant to radiation than luminal-type breast cancer cells. ERα expression may have major roles in modulating breast cancer cell radiosensitivity.

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“…28,63e65 Patients with luminal B (ER, PR, and HER2 positive) and HER2-overexpressing phenotypes had significantly higher risk of recurrence. 17,29,63,66 There was a high correlation between HG-DCIS, HER2 overexpression, high Ki-67, and lack of ER and PR expression. 24 The discovery of intrinsic molecular subtypes in DCIS has further validated DCIS as a precursor of different subtypes of invasive carcinoma, although these subtypes occur at different frequencies; for example, the frequency of the luminal B and HER2 subtypes is much higher in DCIS compared with IBC, and the frequency of the luminal A subtype is much higher in IBC compared with DCIS.…”

Section: Intrinsic Subtypesmentioning

confidence: 97%

Morphologic and Molecular Features of Breast Ductal Carcinoma in Situ

Sanati

2019

The American Journal of Pathology

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Ductal carcinoma in situ (DCIS) encompasses a highly heterogeneous group of lesions that differ with regard to their clinical presentations, histologic features, biomarker profiles, genetic abnormalities, and potential for progression. DCIS is a nonobligatory precursor for invasive carcinoma. With the advent of screening mammography, the incidence of DCIS has significantly increased. There is an argument that many of these lesions will not progress to invasive carcinoma within the lifetime of a patient. In addition, many studies have found enormous heterogeneity within DCIS. There is a need for biomarkers that can stratify patients with DCIS into different prognostic groups based on the biology of the disease. Estrogen and progesterone receptors are the established biomarkers that are used for clinical decision making. In addition, a number of biomarkers, such as human epidermal growth factor receptor 2 protein, p53 tumor suppressor gene, Ki-67 proliferation marker, and tumor-infiltrating lymphocytes, carry prognostic significance, although their use is considered investigational and has not been transferred to clinical practice. On the molecular level, low-grade and high-grade DCIS have different molecular alterations, and the intrinsic molecular subtypes that exist in invasive carcinoma also exist in DCIS with prognostic implications. In this article, we review the morphologic features, prognostic biomarkers, and molecular features of DCIS.

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Impact of hormonal status on outcome of ductal carcinoma in situ treated with breast-conserving surgery plus radiotherapy: Long-term experience from two large-institutional series

Cited by 9 publications

References 32 publications

Impact of hormonal status on ductal carcinoma in situ of the breast: Outcome and prognostic factors

Impact of hormonal status on ductal carcinoma in situ of the breast: Outcome and prognostic factors

Estrogen Receptor Mediates the Radiosensitivity of Triple-Negative Breast Cancer Cells

Morphologic and Molecular Features of Breast Ductal Carcinoma in Situ

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