Incidence of and Treatment for Ductal Carcinoma In Situ of the Breast

Ernster, Virginia L.; Barclay, John M. G.; Kerlikowske, Karla; Grady, Deborah; Henderson, I. Craig

doi:10.1001/jama.1996.03530360023033

Cited by 500 publications

(211 citation statements)

References 36 publications

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“…Ernster et al (1996) found that the proportion of patients with DCIS who were treated with mastectomy decreased from 71% in 1983 to 44% in 1992 (Ernster et al, 1996). The authors also noted that 44% of the patients in 1992 who underwent lumpectomy received RT.…”

Section: Discussionmentioning

confidence: 98%

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Ozkan-Gurdal¹,

Cabıoğlu²,

Özçınar³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Whether sentinel lymph node biopsy (SLNB) should be performed in patients with pure ductal carcinoma in situ (DCIS) of the breast has been a question of debate over the last decade. The aim of this study was to identify factors associated with microinvasive disease and determine the criteria for performing SLNB in patients with DCIS. Materials and Methods: 125 patients with DCIS who underwent surgery between January 2000 and December 2008 were reviewed to identify factors associated with DCIS and DCIS with microinvasion (DCISM). Results: 88 patients (70.4%) had pure DCIS and 37 (29.6%) had DCISM. Among 33 DCIS patients who underwent SLNB, one patient (3.3%) was found to have isolated tumor cells in her biopsy, whereas 1 of 14 (37.8%) patients with DCISM had micrometastasis (7.1%). Similarly, of 16 patients (18.2%) with pure DCIS and axillary lymph node dissection (ALND) without SLNB, none had lymph node metastasis. Furthermore, of 20 patients with DCISM and ALND, only one (5%) had metastasis. In multivariate analysis, the presence of comedo necrosis [relative risk (RR)=4.1, 95% confidence interval (CI)=1.6-10.6, P=0.004], and hormone receptor (ER or PR) negativity (RR=4.0, 95%CI=1.5-11, P=0.007), were found to be significantly associated with microinvasion. Conclusions: Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with comedo necrosis or hormone receptor negativity are more likely to have a microinvasive component in definitive pathology following surgery, and should be considered for SLNB procedure along with patients who will undergo mastectomy due to DCIS.

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Section: Discussionmentioning

confidence: 98%

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Ozkan-Gurdal¹,

Cabıoğlu²,

Özçınar³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Despite the technological advances in detecting these lesions, their biological significance and natural history are not well understood. Five percent to 10% of women diagnosed with DCIS who are treated with lumpectomy alone develop invasive cancer within 5 years and a similar group develops subsequent DCIS (5). Although adjuvant treatment with radiation and tamoxifen has reduced the rates of subsequent breast cancer, these treatment regimens have not affected death rates from breast cancer (6,7).…”

Section: Introductionmentioning

confidence: 99%

Mammography and Ultrasound Imaging of Preinvasive and Invasive Canine Spontaneous Mammary Cancer and Their Similarities to Human Breast Cancer

Mohammed¹,

Meloni²,

Parpaglia³

et al. 2011

Cancer Prevention Research

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Understanding the evolution of proliferative breast disease such as atypical hyperplasia and carcinoma in situ is essential for clinical management of women diagnosed with these lesions. Therefore, an animal model that faithfully represents human breast disease in every aspect from spontaneity of dysplasia onset, histopathologic features, and genetics to clinical outcome is needed. Previously, we studied canine spontaneous atypical hyperplasia and ductal carcinoma in situ (low, intermediate, and high grade) and reported their similarities to human lesions in histopathologic and molecular features as well as prevalence. To further validate the resemblance of these lesions to humans, we examined their mammographic and sonographic characteristics in comparison with those of human's as well as the potential of the human Breast Imaging Reporting and Data System (BI-RADS) to predict canine disease. Nonlesional, benign, and malignant mammary glands of dogs presented to Sassari Veterinary Hospital were imaged using mammography and ultrasonography. The images where then analyzed and statistically correlated with histopathologic findings and to their similarities to humans. Our results showed that canine mammary preinvasive lesions, benign, and malignant tumors have mammographic abnormalities, including the presence, pattern, and distribution of macrocalcification and microcalcification, similar to their human counterparts. BI-RADS categorization is an accurate predictor of mammary malignancy in canine, with 90% sensitivity and 82.8% specificity. The similarities of mammographic images and the ability of BI-RADS to predict canine mammary malignances with high specificity and sensitivity further confirm and strengthen the value of dog as a model to study human breast premalignancies for the development of prognostic biomarkers.

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“…Although established markers of tumour behaviour, including tumour size and nodal status are applicable for this group of patients, tissue-based markers that can predict the risk of progression and recurrence would improve the ability to identify those who would benefit from the treatment (Bennington et al, 1992;Ernster et al, 1996;Tabar et al, 2000). Indeed, several such markers, such as tumour grade and estrogen receptor (ER) status are well established.…”

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confidence: 99%

Carbonic anhydrase XII is a marker of good prognosis in invasive breast carcinoma

et al. 2003

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Hypoxia and pH influence gene expression in tumours, and it is becoming increasingly clear that the pattern of genes expressed by a tumour determines its growth and survival characteristics. Hypoxia-inducible factor-1 (HIF-1) is a key mediator of the cellular response to hypoxia and high HIF-1 expression has been identified as a poor prognostic factor in tumours. Recently, we identified the tumour-associated carbonic anhydrases (CA), CA9 and CA12 as hypoxia-inducible in tumour cell lines. Furthermore, we identified CA IX to be a poor prognostic factor in breast cancer. The aim of this study was to assess the prognostic significance of CA XII. CA XII expression was studied by immunohistochemistry in a series of 103 cases of invasive breast cancer and any association with recognised prognostic factors or relation with the outcome was examined. CA XII expression was present in 77 out of 103 (75%) cases and was associated with lower grade (P ¼ 0.001), positive estrogen receptor status (Po0.001), and negative epidermal growth factor receptor status (Po0.001). Furthermore, although CA XII expression was associated with an absence of necrosis (Po0.001), expression of CA XII in some high-grade tumours was induced in regions directly adjacent to morphological necrosis. Additionally, using univariate analysis, CA XII positive tumours were associated with a lower relapse rate (P ¼ 0.04) and a better overall survival (P ¼ 0.01). In conclusion, CA XII expression is influenced both by factors related to differentiation and hypoxia in breast cancer in vivo and CA XII expression is associated with a better prognosis in an unselected series of invasive breast carcinoma patients.

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Incidence of and Treatment for Ductal Carcinoma In Situ of the Breast

Cited by 500 publications

References 36 publications

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Factors Predicting Microinvasion in Ductal Carcinoma in situ

Mammography and Ultrasound Imaging of Preinvasive and Invasive Canine Spontaneous Mammary Cancer and Their Similarities to Human Breast Cancer

Carbonic anhydrase XII is a marker of good prognosis in invasive breast carcinoma

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