Tumor-Infiltrating Lymphocytes in a Contemporary Cohort of Women with Ductal Carcinoma In Situ (DCIS)

Darvishian, Farbod; Özerdem, Uğur; Adams, Sylvia; Chun, Jennifer; Pirraglia, Elizabeth; Kaplowitz, Elianna; Guth, Amber; Axelrod, Deborah; Shapiro, Richard L.; Price, Alison; Troxel, Andrea B.; Schnabel, Freya; Roses, Daniel F.

doi:10.1245/s10434-019-07562-x

Cited by 17 publications

(22 citation statements)

References 33 publications

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“…They also noted that the stromal area around DCIS can be difficult to identify and ill-defined. Darvishian et al 12 attempted to use the working group guidelines for TIL assessment in DCIS, but found that it was not straightforward, and demonstrated suboptimal reproducibility, which was our observation as well. We found that determination of the area to evaluate for stromal TILs was particularly challenging in cases in which DCIS was widely distributed.…”

Section: Discussionsupporting

confidence: 60%

“…One recent study, which reported using guidelines from the International Immuno-Oncology Biomarker Working Group for TILs assessment, included 69 patients with DCIS, and concluded that dense stromal TILs were significantly associated with recurrence. 12 Among the three methodologies that we used to assess TILs in DCIS, stromal TILs showed the lowest concordance rate among pathologists, followed by touching TILs. Assessment for circumferential TILs showed near-perfect agreement.…”

Section: Discussionmentioning

confidence: 91%

“…studied 534 DCIS cases, and found no significant association between stromal TILs and recurrence when using a 5% cut‐off. One recent study, which reported using guidelines from the International Immuno‐Oncology Biomarker Working Group for TILs assessment, included 69 patients with DCIS, and concluded that dense stromal TILs were significantly associated with recurrence 12 …”

Section: Discussionmentioning

confidence: 99%

“…In DCIS, significant associations have been demonstrated between high grade, necrosis, absent oestrogen receptor (ER) expression and positive HER2 status, and dense TILs. [12][13][14][15] However, the association between dense TILs and DCIS recurrence has not been firmly established. 13,15 Assessment of stromal TILs, as detailed by the International Immuno-Oncology Biomarker Working Group, did not demonstrate an association with DCIS recurrence.…”

Section: Introductionmentioning

confidence: 99%

“…Information on the role of the immune response in DCIS recurrence and progression is an area of intense investigation. In DCIS, significant associations have been demonstrated between high grade, necrosis, absent oestrogen receptor (ER) expression and positive HER2 status, and dense TILs 12–15 . However, the association between dense TILs and DCIS recurrence has not been firmly established 13,15 .…”

Section: Introductionmentioning

confidence: 99%

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Tumour‐infiltrating lymphocytes in ductal carcinoma in situ (DCIS)—assessment with three different methodologies and correlation with Oncotype DX DCIS Score

et al. 2020

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Tumour-infiltrating lymphocytes in ductal carcinoma in situ (DCIS)-assessment with three different methodologies and correlation with Oncotype DX DCIS Score Aims: Tumour-infiltrating lymphocytes (TILs) are prognostic in invasive breast cancer; however, their prognostic significance in ductal carcinoma in situ (DCIS) has not been established. The Oncotype DX (ODX) Breast DCIS Score test is a genomic assay used to predict the local recurrence risk. The aims of this study were to quantify TILs in DCIS by the use of three methodologies, and correlate them with the ODX DCIS Score. Methods and results: We studied 97 DCIS cases, all with an ODX DCIS Score. Cases with a low ODX DCIS Score were considered as one group, and those with an intermediate/high ODX Score were considered together. TILs were quantified on haematoxylin and eosin-stained slides. The methodologies used to quantify TILS included assessment of stromal TILs, assessment of touching TILs, and assessment of circumferential TILS. In cases with >5% stromal TILS, the percentage of stromal TILS was considered to be high. In cases with a mean number of more than five touching TILs per DCIS duct, TILs were considered to be present. The ODX DCIS Score was intermediate/ high in 27 (28%) cases and low in 70 (72%) cases. There were >5% stromal TILs in 33 (34%) cases, and more than five touching TILs per DCIS duct in 15 (15%) cases; circumferential TILs were present in nine (9%) cases. In univariate analysis, a low ODX DCIS Score showed significant associations with absent touching TILS (P = 0.027), stromal TILs < 5% (P = 0.031), and absent circumferential TILs (P = 0.002). In logistic regression analysis adjusted for necrosis and nuclear grade, touching TILs and circumferential TILs showed significant associations with the ODX DCIS Score, whereas stromal TILs did not. Conclusions: Our results suggest that both the presence of TILs and the spatial arrangement of TILs or close proximity of TILs to DCIS, and TILs touching or encircling DCIS, may be predictive of recurrence.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%