Predictors of recurrence for ductal carcinoma in situ after breast-conserving surgery

Benson, John R.; Wishart, Gordon

doi:10.1016/s1470-2045(13)70135-9

Cited by 90 publications

(76 citation statements)

References 57 publications

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“…4 However, considering potential long-term side effects of radiation therapy, it seems prudent to identify a population of patients to observe without further therapy. Studies have shown that certain clinical and pathological features of DCIS may be prognostic of local and/or invasive recurrence following surgical excision [6,7,10]. For instance, many studies have suggested that the tumor size is a strong predictor of local recurrence [7,11].…”

Section: Dcis Accounts For Approximately 20% Of All Newly Diagnosed Bmentioning

confidence: 99%

Ductal carcinoma in situ of the breast: the importance of morphologic and molecular interactions

2016

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Section: Dcis Accounts For Approximately 20% Of All Newly Diagnosed Bmentioning

confidence: 99%

Ductal carcinoma in situ of the breast: the importance of morphologic and molecular interactions

2016

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“…Before the advent of screening, DCIS represented only 2-5% of symptomatic breast cancers; at present it accounts for approximately 20-25 % of all and up to half of screen-detected breast cancers [1,2]. DCIS is defined as local disease involving proliferation of abnormal epithelial cells limited by the basement membrane without stromal invasion and represents a non-obligate precursor of invasive breast cancer (IBC).…”

Section: Molecular Markers As Prognostic Factors In Dcis and Small Inmentioning

confidence: 99%

“…DCIS is defined as local disease involving proliferation of abnormal epithelial cells limited by the basement membrane without stromal invasion and represents a non-obligate precursor of invasive breast cancer (IBC). Not all DCIS progress to invasive disease if untreated but the estimated range is 25-50 % [1,3,4]. Thus, once DCIS has been detected, treatment is obligatory although the majority of women with DCIS are not destined to recur let alone die of their disease [3].…”

Section: Molecular Markers As Prognostic Factors In Dcis and Small Inmentioning

confidence: 99%

“…Thus, once DCIS has been detected, treatment is obligatory although the majority of women with DCIS are not destined to recur let alone die of their disease [3]. Moreover, present technologies do not allow accurate risk stratification such that intensity of treatment can be tailored to risk of recurrence and progression to invasive disease [1]. Therefore many women are either over-or undertreated and there is pressing need for novel diagnostic approaches to improve risk stratification [3,5].…”

Section: Molecular Markers As Prognostic Factors In Dcis and Small Inmentioning

confidence: 99%

“…Nevertheless, other researchers also reported an increased risk of recurrence in the HER2-like and Luminal-HER2 groups [32]. Taken together, since IHC surrogates are readily available they represent an attractive pragmatic approach for studies on risk assessment of molecular subtypes of DCIS [1]. Clearly validation datasets are needed to establish whether this marker panel could replace traditional risk factors or be amalgamated into a model or nomogram.…”

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Molecular Markers as Prognostic Factors in DCIS and Small Invasive Breast Cancers

Sänger

Engels²,

Graf

et al. 2014

Geburtshilfe Frauenheilkd

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!Ductal carcinoma in situ (DCIS) accounts for up to half of screen-detected breast cancers and thus constitutes a major public health problem. Despite effective current treatment many patients with DCIS are either over-or undertreated because of the paucity of precise models to predict recurrence or progression. The combination of clinical and molecular factors as already applied for invasive disease may help to build such models also for DCIS. We compared 53 DCIS (36.6 %) and 92 (63.4 %) invasive breast cancer cases and found no significant differences in age, receptor status of ER, PR, and HER2, and the use of radiotherapy. Interestingly, the proportion of disseminated tumor cells (DTC) did also not significantly differ between DCIS and invasive cases (p = 0.57). A negative PR status was associated with the detection of DTCs (p = 0.026). We then compared relationships of clinical parameters and biomarkers with patientsʼ prognosis in 43 DCIS and 40 small invasive tumors ≤ 5 mm (T1a). ER negativity was associated with shorter relapse free survival in the complete cohort (p = 0.004) and showed a trend in both subgroups (p = 0.053 for DCIS and p = 0.046 for T1a, respectively). In conclusion, we found markedly similar properties of both DCIS and small invasive breast cancers with respect to the distribution of several parameters as well as to the prognostic value of biomarkers. DCIS with a luminal phenotype seem to be characterized by a favourable prognosis. Interessanterweise unterschied sich auch die Häufigkeit der Detektion disseminierter Tumorzellen (DTZ) nicht signifikant zwischen DCIS und invasiven Fällen (p = 0,57). Ein negativer Progesteronrezeptor-Status war mit dem DTZ-Nachweis assoziiert (p = 0,026). Untersucht wurde ebenfalls der Zusammenhang von klinischen Parametern und Biomarkern mit der Prognose bei 43 DCIS und 40 invasiven T1a-Karzinomen. Negativität für den Östrogenrezeptor zeigte hierbei einen signifikanten Zusammenhang zu einem kürzeren krankheitsfreien Intervall in der Gesamtkohorte (p = 0,004) und einen Trend in beiden Subgruppen (p = 0,053 bei DCIS bzw. p = 0,046 bei T1a). Zusammenfassend fanden wir sehr ähnliche Charakteristika bez. der Verteilung verschiedener Parameter und des prognostischen Werts von Biomarkern sowohl bei DCIS als auch invasiven Karzinomen. DCIS mit einem luminalen Phänotyp scheint durch eine günstigere Prognose gekennzeichnet zu sein. Zusammenfassung

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Survival Benefit of Breast Surgery for Low-Grade Ductal Carcinoma In Situ

Sagara

Mallory

Wong³

et al. 2015

JAMA Surg

173

101

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Predictors of recurrence for ductal carcinoma in situ after breast-conserving surgery

Cited by 90 publications

References 57 publications

Ductal carcinoma in situ of the breast: the importance of morphologic and molecular interactions

Ductal carcinoma in situ of the breast: the importance of morphologic and molecular interactions

Molecular Markers as Prognostic Factors in DCIS and Small Invasive Breast Cancers

Survival Benefit of Breast Surgery for Low-Grade Ductal Carcinoma In Situ

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