p14ARF expression in invasive breast cancers and ductal carcinoma in situ– relationships to p53 and Hdm2

With the advent of screening mammography, the incidence of ductal carcinoma in situ (DCIS) has increased. DCIS accounts for around 20% of breast cancers diagnosed at present. The histiocytoid variant of clear cell DCIS is a rare subtype of DCIS, characterized by epithelial cells with a clear and foamy cytoplasm. Histiocytoid DCIS serves as a potential diagnostic pitfall, since it can be easily mistaken for intraductal collections of foamy macrophages. In this article, we report a particular case of biphasic DCIS, characterized by an extensive histiocytoid-type clear cell component and a conventional “non-clear” cell component. Both components presented with HER2 protein overexpression. We discuss the diagnostic challenge and differential diagnosis of clear cell DCIS, as well as the role of HER2 overexpression in DCIS pathogenesis.

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Risk of second primary breast cancers among women with ductal carcinoma in situ of the breast

Breast Cancer Research and Treatment ◽

10.1007/s10549-007-9807-1 ◽

2007 ◽

Vol 111 (3) ◽

pp. 531-540 ◽

Cited By ~ 30

Author(s):

Kaire Innos ◽

Pamela L. Horn-Ross

Keyword(s):

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Second Primary ◽

Breast Cancers

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Endocrine Therapy Initiation among Older Women with Ductal Carcinoma In Situ

Journal of Cancer Epidemiology ◽

10.1155/2017/6091709 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Chelsea Anderson ◽

Aaron N. Winn ◽

Stacie B. Dusetzina ◽

Hazel B. Nichols

Keyword(s):

Older Women ◽

Endocrine Therapy ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Breast Cancers ◽

National Guidelines ◽

Therapy Initiation ◽

Er Positive

Background. Although treatment of ductal carcinoma in situ (DCIS) is controversial, national guidelines recommend considering endocrine therapy for women with estrogen receptor- (ER-) positive DCIS or those undergoing breast conserving surgery (BCS) without radiation. We evaluated uptake and predictors of endocrine therapy use among older women with DCIS. Methods. In the SEER-Medicare database, we identified women aged 65+ years diagnosed with DCIS during 2007–2011. We evaluated demographic, tumor, and treatment characteristics associated with endocrine therapy initiation. Results. Among 2,945 women with DCIS, 41% initiated endocrine therapy (66% tamoxifen, 34% aromatase inhibitors). Initiation was more common among women with ER-positive than ER-negative DCIS (48% versus 16%; HR = 3.75, 95% CI: 2.91–4.83); 28% of women with unknown ER status initiated endocrine therapy. Initiation was less common after BCS alone compared to BCS with radiation (32% versus 50%; HR = 0.69, 95% CI: 0.59–0.80). Conclusions. Less than half of older women with DCIS initiate endocrine therapy to prevent second breast cancers. Our findings suggest use was more common, but not exclusive, among women with ER-positive DCIS, but not among women who underwent BCS alone. Endocrine therapy should be targeted toward patients most likely to benefit from its use.

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Ductal Carcinoma In Situ: Challenges, Opportunities, and Uncharted Waters

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2012.32.228 ◽

2012 ◽

pp. 40-44 ◽

Cited By ~ 1

Author(s):

Abigail W. Hoffman ◽

Catherine Ibarra-Drendall ◽

Virginia Espina ◽

Lance Liotta ◽

Victoria Seewaldt

Keyword(s):

Breast Cancer ◽

Local Recurrence ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

The United States ◽

Targeted Prevention ◽

Breast Cancers ◽

Increased Risk

Overview: Ductal carcinoma in situ (DCIS) is a heterogeneous group of diseases that differ in biology and clinical behavior. Until 1980, DCIS represented less than 1% of all breast cancer cases. With the increased utilization of mammography, DCIS now accounts for 15% to 25% of newly diagnosed breast cancer cases in the United States. Although our ability to detect DCIS has radically improved, our understanding of the pathophysiology and factors involved in its progression to invasive carcinoma is still poorly defined. In many patients, DCIS will never progress to invasive breast cancer and these women are overtreated. In contrast, some DCIS cases are clinically aggressive and the women may be undertreated. We are able to define some of the predictors of aggressive DCIS compared with DCIS of low malignant potential. However, our ability to risk-stratify DCIS is still in its infancy. Clinical risk factors that predict aggressive disease and increased risk of local recurrence include young age at diagnosis, large lesion size, high nuclear grade, comedo necrosis, and involved margins. Treatment factors such as wider surgical margins and radiation therapy reduce the risk of local recurrence. DCIS represents a key intermediate in the stepwise progression to malignancy, but not all aggressive breast cancers appear to have a DCIS intermediate, notably within triple-negative breast cancer. Ongoing studies of the genetic and epigenetic alterations in precancerous breast lesions (atypia and DCIS) as well as the breast microenvironment are important for developing effective early detection and individualized targeted prevention.

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Radiotherapy for ductal carcinoma in situ and risk of second non-breast cancers

Breast Cancer Research and Treatment ◽

10.1007/s10549-017-4410-6 ◽

2017 ◽

Vol 166 (1) ◽

pp. 299-306 ◽

Cited By ~ 4

Author(s):

Diana R. Withrow ◽

Lindsay M. Morton ◽

Rochelle E. Curtis ◽

Sara J. Schonfeld ◽

Amy Berrington de González

Keyword(s):

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Breast Cancers

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Changes in Invasive Breast Cancer and Ductal Carcinoma In Situ Rates in Relation to the Decline in Hormone Therapy Use

Journal of Clinical Oncology ◽

10.1200/jco.2010.29.5121 ◽

2010 ◽

Vol 28 (35) ◽

pp. 5140-5146 ◽

Cited By ~ 25

Author(s):

Ghada N. Farhat ◽

Rod Walker ◽

Diana S.M. Buist ◽

Tracy Onega ◽

Karla Kerlikowske

Keyword(s):

Breast Cancer ◽

Hormone Therapy ◽

Ductal Carcinoma In Situ ◽

Invasive Breast Cancer ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Screening Mammography ◽

Breast Cancers ◽

Cancer Rates

Purpose To assess trends in invasive breast cancer and ductal carcinoma in situ (DCIS) incidence in association with changes in hormone therapy (HT) use in regular mammography screeners. Methods We included 2,071,814 screening mammography examinations performed between January 1997 and December 2006 on 696,385 women age 40 to 79 years; 9,586 breast cancers were diagnosed within 12 months of a screening examination. We calculated adjusted annual rates (mammogram level) for prevalent HT use, incident invasive breast cancer (overall and by tumor histology and estrogen receptor [ER] status), and incident DCIS. Results After a precipitous decrease in HT use in 2002, the incidence of invasive breast cancer decreased significantly in 2002 to 2006 among women age 50 to 69 years (Ptrend(2002–2006) = .005) and 70 to 79 years (Ptrend(2002–2006) = .003) but not in women age 40 to 49 years (Ptrend(2002–2006) = .45). DCIS rates significantly decreased in women age 50 to 69 years after 2002 (Ptrend(2002–2006) = .02). Invasive ductal tumors significantly declined in women age 50 to 69 years and 70 to 79 years in 2002 to 2006. In women age 50 to 69 years, invasive lobular and ER-positive cancer rates declined steadily in 2002 to 2005 (Ptrend(2002–2005) = .02 and .03, respectively), but an elevated rate in 2006 rendered the overall trend nonsignificant (Ptrend(2002–2006) = .89 and .91, respectively). Conclusion In parallel to the sharp decline in HT use in women undergoing regular mammography screening, invasive breast cancer rates decreased in women age 50 to 69 and 70 to 79 years after 2002, and DCIS rates decreased in women age 50 to 69 years, consistent with evidence that HT cessation reduces breast cancer risk. However, the decrease in incidence may have started to level off in 2006; this finding has not been uniformly reported in other populations, warranting further investigation.

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Relationship Between Anthropometric Factors and Risk of Second Breast Cancer Among Women With a History of Ductal Carcinoma In Situ

JNCI Cancer Spectrum ◽

10.1093/jncics/pky020 ◽

2018 ◽

Vol 2 (2) ◽

Cited By ~ 1

Author(s):

Meghan R Flanagan ◽

Mei-Tzu C Tang ◽

Michelle L Baglia ◽

Peggy L Porter ◽

Kathleen E Malone ◽

...

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Breast Cancers ◽

Increased Risk ◽

History Of ◽

Second Breast Cancer ◽

The Impact

AbstractBackgroundWomen with ductal carcinoma in situ (DCIS) have an elevated risk of a second breast cancer, but few data are available regarding the impact of modifiable lifestyle factors on this risk.MethodsIn a population-based case–control patient study of women with a history of DCIS in western Washington diagnosed between 1996 and 2013, 497 patients diagnosed with DCIS and a second ipsilateral or contralateral invasive or in situ breast cancer were enrolled. There were 965 matched control patients with one DCIS diagnosis. Associations between anthropometric factors and risk of an invasive or in situ second breast cancer event were evaluated using conditional logistic regression. Statistical tests were two-sided.ResultsObesity (body mass index [BMI] ≥ 30 kg/m2) at initial DCIS diagnosis was associated with a 1.6-fold (95% confidence interval [CI] = 1.2 to 2.2) increased risk of any second breast cancer and a 2.2-fold increased risk of a contralateral second breast cancer (95% CI = 1.4 to 3.3) compared with normal weight women (BMI < 25 kg/m2). BMI and weight, both at initial DCIS diagnosis and at the time of the second breast cancer diagnosis, were positively associated with risk of any second and second invasive breast cancers (odds ratio = 1.01–1.04, all P ≤ .03).ConclusionsAlthough additional confirmatory studies are needed, obesity appears to be an important contributor to the risk of second breast cancers within the growing population of women with DCIS. This has potential clinical relevance with respect to identifying which women with a history of DCIS may require more careful monitoring and who may benefit from lifestyle modifications.

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