scholarly journals DCIS genomic signatures define biology and correlate with clinical outcome: a Human Tumor Atlas Network (HTAN) analysis of TBCRC 038 and RAHBT cohorts

2021 ◽  
Author(s):  
Siri H Strand ◽  
Belen Rivero-Gutierrez ◽  
Kathleen E Houlahan ◽  
Jose A Seoane ◽  
Lorraine King ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Outcome ◽  
Immune Cell ◽  
De Novo ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Expression Patterns ◽  
Human Tumor ◽  
Multiscale Approach

Ductal carcinoma in situ (DCIS) is the most common precursor of invasive breast cancer (IBC), with variable propensity for progression. We have performed the first multiscale, integrated profiling of DCIS with clinical outcomes by analyzing 677 DCIS samples from 481 patients with 7.1 years median follow-up from the Translational Breast Cancer Research Consortium (TBCRC) 038 study and the Resource of Archival Breast Tissue (RAHBT) cohorts. We made observations on DNA, RNA, and protein expression, and generated a de novo clustering scheme for DCIS that represents a fundamental transcriptomic organization at this early stage of breast neoplasia. Distinct stromal expression patterns and immune cell compositions were identified. We found RNA expression patterns that correlate with later events. Our multiscale approach employed in situ methods to generate a spatially resolved atlas of breast precancers, where complementary modalities can be directly compared and correlated with conventional pathology findings, disease states, and clinical outcome.

Long-term risk of second malignancies in women with ductal carcinoma in situ or early-stage invasive breast cancer after breast conservation treatment.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12103-e12103
Author(s):  
Carolyn J. Kushner ◽  
Wei-Ting Hwang ◽  
Lawrence J. Solin ◽  
Neha Vapiwala
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Breast Conservation ◽  
Conservation Treatment ◽  
Breast Conservation Treatment

e12103 Background: Women with ductal carcinoma in situ (DCIS) or early stage breast cancer have a good prognosis after breast conservation treatment (BCT), and are at risk for second malignant neoplasms (SMNs). The long-term risk of SMNs is not well established and carries important public health implications. Methods: A total of 755 women with DCIS or stage I-II invasive breast cancer underwent breast-conserving surgery followed by definitive breast irradiation between 1995 and 2001. Systemic therapy (chemotherapy and/or hormonal therapy) was given to 73% of the patients. We have previously described patient demographics and 15-year oncologic outcomes in detail (Vapiwala, Cancer, 2017). The patient records were reviewed for development of SMNs. SMNs of any anatomic site (other than contralateral breast cancer and basal/squamous cell carcinoma of the skin) were included for analysis. The Kaplan-Meier method was used to determine the rate of SMNs over time. Median follow-up was 13.8 years. Results: The 5-, 10-, and 15-year rates of developing any SMN were 3.6% (95% CI 2.4-5.3%), 7.8% (95% CI 6.0-10.2%), and 12.7% (95% CI 10.2-15.8%). The most common SMNs were uterine (n=12), leukemia/lymphoma (n=11), melanoma (n=10), ovarian (n=9), and lung (n=7). Conclusions: Development of SMNs is a substantial risk for a protracted period of time following BCT. Clinical patterns of specific SMN histologies, locations and time course of development suggest potential opportunities for screening and treatment to guide patient survivorship clinics and protocols.

Prediction Model For Extensive Ductal Carcinoma In Situ Around Early-Stage Invasive Breast Cancer

2016 ◽  
Vol 51 (7) ◽  
pp. 462-468 ◽  
Author(s):  
Floortje M. Knuttel ◽  
Bas H.M. van der Velden ◽  
Claudette E. Loo ◽  
Sjoerd G. Elias ◽  
Jelle Wesseling ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prediction Model ◽  
Ductal Carcinoma In Situ ◽  
Invasive Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Early Stage

Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update

2017 ◽  
Vol 35 (5) ◽  
pp. 561-564 ◽  
Author(s):  
Gary H. Lyman ◽  
Mark R. Somerfield ◽  
Linda D. Bosserman ◽  
Cheryl L. Perkins ◽  
Donald L. Weaver ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Node Biopsy

Purpose To provide current recommendations on the use of sentinel node biopsy (SNB) for patients with early-stage breast cancer. Methods PubMed and the Cochrane Library were searched for randomized controlled trials, systematic reviews, meta-analyses, and clinical practice guidelines from 2012 through July 2016. An Update Panel reviewed the identified abstracts. Results Of the eight publications identified and reviewed, none prompted a change in the 2014 recommendations, which are reaffirmed by the updated literature review. Conclusion Women without sentinel lymph node (SLN) metastases should not receive axillary lymph node dissection (ALND). Women with one to two metastatic SLNs who are planning to undergo breast-conserving surgery with whole-breast radiotherapy should not undergo ALND (in most cases). Women with SLN metastases who will undergo mastectomy should be offered ALND. These three recommendations are based on randomized controlled trials. Women with operable breast cancer and multicentric tumors, with ductal carcinoma in situ, who will undergo mastectomy, who previously underwent breast and/or axillary surgery, or who received preoperative/neoadjuvant systemic therapy may be offered SNB. Women who have large or locally advanced invasive breast cancer (tumor size T3/T4), inflammatory breast cancer, or ductal carcinoma in situ (when breast-conserving surgery is planned) or are pregnant should not undergo SNB.

Overdiagnosis and Overtreatment of Breast Cancer

2012 ◽  
pp. e40-e45
Author(s):  
Michael Alvarado ◽  
Elissa Ozanne ◽  
Laura Esserman
Keyword(s):  
Breast Cancer ◽  
Lower Risk ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Invasive Cancer ◽  
Molecular Testing ◽  
Low Grade ◽  
Breast Cancers ◽  
Molecular Tests

Overview: Breast cancer is the most common cancer in women. Through greater awareness, mammographic screening, and aggressive biopsy of calcifications, the proportion of low-grade, early stage cancers and in situ lesions among all breast cancers has risen substantially. The introduction of molecular testing has increased the recognition of lower risk subtypes, and less aggressive treatments are more commonly recommended for these subtypes. Mammographically detected breast cancers are much more likely to have low-risk biology than symptomatic tumors found between screenings (interval cancers) or that present as clinical masses. Recognizing the lower risk associated with these lesions and the ability to confirm the risk with molecular tests should safely enable the use of less aggressive treatments. Importantly, ductal carcinoma in situ (DCIS) lesions, or what have been called stage I cancers, in and of themselves are not life-threatening. In situ lesions have been treated in a manner similar to that of invasive cancer, but there is little evidence to support that this practice has improved mortality. It is also being recognized that DCIS lesions are heterogeneous, and a substantial proportion of them may in fact be precursors of more indolent invasive cancers. Increasing evidence suggests that these lesions are being overtreated. The introduction of molecular tests should be able to help usher in a change in approach to these lesions. Reclassifying these lesions as part of the spectrum of high-risk lesions enables the use of a prevention approach. Learning from the experience with active surveillance in prostate cancer should empower the introduction of new approaches, with a focus on preventing invasive cancer, especially given that there are effective, United States Food and Drug Administration (FDA)-approved breast cancer preventive interventions.

scholarly journals Severe depression more common in patients with ductal carcinoma in situ than early-stage invasive breast cancer patients

2017 ◽  
Vol 167 (1) ◽  
pp. 205-213 ◽  
Author(s):  
M. L. Gregorowitsch ◽  
H. J. G. D. van den Bongard ◽  
D. A. Young-Afat ◽  
J. P. Pignol ◽  
C. H. van Gils ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Ductal Carcinoma In Situ ◽  
Invasive Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Severe Depression ◽  
Breast Cancer Patients

scholarly journals Analysis of Key Radiographic Characteristics of Early Invasive Breast Cancer, Stages T₁ₐ₋bN₀M₀ and DCIS

2021 ◽  
Vol 4 (1) ◽  
pp. 9-19
Author(s):  
G. S. Alieva ◽  
G. P. Korzhenkova ◽  
I. V. Kolyadina
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma In Situ ◽  
Invasive Breast Cancer ◽  
Carcinoma In Situ ◽  
World Literature ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Malignant Neoplasm ◽  
Morphological Examination

Relevance: The systematization of radiological signs of microcarcinomas will increase the frequency of detection of the disease at an early stage and maximize the effectiveness of breast cancer treatment.Purpose: To assess the key radiological characteristics of early forms of breast cancer (invasive tumors up to 1.0 cm and ductal carcinoma in situ).Material and methods: The key radiological characteristics were studied in 110 patients with verified early forms of breast cancer: ductal carcinoma in situ (DCIS), invasive breast cancer up to 1 cm in size according to the morphological examination of the surgical material in the absence of signs of regional and distant metastasis — stage p T₁ₐ₋bN₀M₀.Results: The main radiological signs detected in mammography (MG) in early breast cancer were the nodular mass without microcalcifications — in 26 cases (23.9 %), the nodule and microcalcifications — in 35 cases (32.1 %), in 27 patients (24.8 %) — microcalcifications without a tumor node. In addition, in 17 cases (15.6 %) there was a violation of the architectonics or focal asymmetry, and in 4 patients (3.7 %) no signs of a malignant process were revealed at all with MG. The revealed changes in the breast in most patients (83 cases, 76.1 %) were interpreted as BIRADS 5, which indicates an extremely high probability of the presence of a malignant neoplasm. In 9 cases (8.3 %) after mammography, the diagnosis was interpreted as BIRADS 4, in 16 (14.7 %) cases the category BIRADS 0 was assigned, which required additional examination methods, and only in 1 patient (0.9 %) the revealed changes were interpreted as benign.Conclusions: Mammography performed in 92 patients (84.4 %), based on the assessment of radiological signs, to establish the BIRADS 4/5 category, which served as the basis for performing a biopsy and verifying the diagnosis. However, in 15 % there were diagnostic difficulties in interpreting the data, which confirms the data of the world literature on the complexity of the differential diagnosis of microcarcinomas. 

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