Blurry Boundaries: Do Epithelial Borderline Lesions of the Breast and Ductal Carcinoma In Situ Have Similar Rates of Subsequent Invasive Cancer?

Purpose: The question of overtreatment of ductal carcinoma in situ (DCIS) was raised because a significant proportion of especially low-grade DCIS lesions never progress to invasive cancer. The rationale for the present study was to analyze the value of stereotactic vacuum-assisted biopsy (VAB) for complete removal of DCIS, focusing on the relationship between the absence of residual microcalcifications after stereotactic VAB and the histopathological diagnosis of the definitive surgical specimen. Patients and Methods: Data of 58 consecutive patients diagnosed with DCIS by stereotactic VAB in a single breast center between 2012 and 2017 were analyzed. Patient records from the hospital information system were retrieved, and mammogram reports and images as well as histopathology reports were evaluated. The extent of microcalcifications before and after biopsy as well as the occurrence of DCIS in biopsy and definitive surgical specimens were analyzed and correlated. Results: There was no correlation between the absence of residual microcalcifications in the post-biopsy mammogram and the absence of residual DCIS in the final surgical specimen (p = 0.085). Upstaging to invasive cancer was recorded in 4 cases (13%) but occurred only in the group that had high-grade DCIS on biopsy. Low-grade DCIS was never upgraded to high-grade DCIS in the definitive specimen. Conclusions: The radiological absence of microcalcifications after stereotactic biopsy does not rule out residual DCIS in the final surgical specimen. Since upstaging to invasive cancer is seen in a substantial proportion of high-grade DCIS, the surgical excision of high-grade DCIS should remain the treatment of choice.

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Isobaric Tags for Relative and Absolute Quantitation in Proteomic Analysis of Potential Biomarkers in Invasive Cancer, Ductal Carcinoma In Situ, and Mammary Fibroadenoma

Frontiers in Oncology ◽

10.3389/fonc.2020.574552 ◽

2020 ◽

Vol 10 ◽

Author(s):

Hao Wu ◽

Xian-Yu Zhang ◽

Ming Niu ◽

Fei-Feng Li ◽

Song Gao ◽

...

Keyword(s):

Ductal Carcinoma In Situ ◽

Proteomic Analysis ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Invasive Cancer ◽

Absolute Quantitation ◽

Isobaric Tags ◽

Potential Biomarkers

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Risk factors for the development of invasive cancer in unresected ductal carcinoma in situ

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2017.12.007 ◽

2018 ◽

Vol 44 (4) ◽

pp. 429-435 ◽

Cited By ~ 28

Author(s):

Anthony J. Maxwell ◽

Karen Clements ◽

Bridget Hilton ◽

David J. Dodwell ◽

Andrew Evans ◽

...

Keyword(s):

Risk Factors ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Invasive Cancer

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Study of Estrogen Receptor and Progesterone Receptor Expression in Breast Ductal Carcinoma In Situ by Immunohistochemical Staining in ER/PgR-Negative Invasive Breast Cancer

ISRN Oncology ◽

10.5402/2011/673790 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Andrei Dobrescu ◽

Monique Chang ◽

Vatsala Kirtani ◽

George K. Turi ◽

Randa Hennawy ◽

...

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma In Situ ◽

Invasive Breast Cancer ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Receptor Expression ◽

Invasive Cancer ◽

Positive Staining ◽

Receptor Status

Background. To our knowledge, the hormone receptor status of noncontiguous ductal carcinoma in situ (DCIS) occurring concurrently in ER/PgR-negative invasive cancer has not been studied. The current study was undertaken to investigate the ER/PgR receptor status of DCIS of the breast in patients with ER/PgR-negative invasive breast cancer. Methods. We reviewed the immunohistochemical (IHC) staining for ER and PgR of 187 consecutive cases of ER/PgR-negative invasive breast cancers, collected from 1995 to 2002. To meet the criteria for the study, we evaluated ER/PgR expression of DCIS cancer outside of the invasive breast cancer. Results. A total of 37 cases of DCIS meeting the above criteria were identified. Of these, 16 cases (43.2%) showed positive staining for ER, PgR, or both. Conclusions. In our study of ER/PgR-negative invasive breast cancer we found that in 8% of cases noncontiguous ER/PR-positive DCIS was present. In light of this finding, it may be important for pathologists to evaluate the ER/PgR status of DCIS occurring in the presence of ER/PgR-negative invasive cancer, as this subgroup could be considered for chemoprevention.

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P5-01-04: FOXP3 Positive Regulatory T Lymphocytes and Epithelial FOXP3 Expression in Synchronous Normal, Ductal Carcinoma In Situ and Invasive Cancer of the Breast.

10.1158/0008-5472.sabcs11-p5-01-04 ◽

2011 ◽

Author(s):

A Lal ◽

L Chan ◽

S DeVries ◽

K Chin ◽

CC Benz ◽

...

Keyword(s):

T Lymphocytes ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Foxp3 Expression ◽

Invasive Cancer ◽

Regulatory T Lymphocytes

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Disparities in Reconstruction Rates after Mastectomy for Ductal Carcinoma in Situ (DCIS): Patterns of Care and Factors Associated with the Use of Breast Reconstruction for DCIS Compared with Invasive Cancer

Annals of Surgical Oncology ◽

10.1245/s10434-011-2010-y ◽

2011 ◽

Vol 18 (11) ◽

pp. 3210-3219 ◽

Cited By ~ 32

Author(s):

Laura Kruper ◽

Xinxin Xu ◽

Katherine Henderson ◽

Leslie Bernstein

Keyword(s):

Breast Reconstruction ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Invasive Cancer ◽

Patterns Of Care ◽

Factors Associated

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Ductal Carcinoma In Situ in BRCA Mutation Carriers

Journal of Clinical Oncology ◽

10.1200/jco.2005.04.0345 ◽

2007 ◽

Vol 25 (6) ◽

pp. 642-647 ◽

Cited By ~ 45

Author(s):

E. Shelley Hwang ◽

Jane L. McLennan ◽

Dan H. Moore ◽

Beth B. Crawford ◽

Laura J. Esserman ◽

...

Keyword(s):

High Risk ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Prediction Models ◽

Ductal Carcinoma ◽

Brca Mutation ◽

Univariate Analysis ◽

Invasive Cancer ◽

Mutation Carriers

Purpose The current literature suggests that ductal carcinoma in situ (DCIS) of the breast is infrequently diagnosed in patients with BRCA germline mutations. We studied women at high risk of hereditary breast cancer syndromes who underwent testing for BRCA1 and BRCA2 to estimate DCIS prevalence and incidence in known BRCA-positive women compared with high-risk women who were mutation negative. Methods We analyzed breast event outcomes in a retrospective cohort of 129 BRCA-positive and 269 BRCA-negative women undergoing genetic testing for a BRCA mutation between September 1996 and December 2003 at University of California, San Francisco. We estimated the frequency of DCIS and invasive cancer and time to breast events from birth using a Cox proportional hazard model for competing risks. Histologic grade of DCIS was also compared between groups. Results Among BRCA carriers, 48 (37%) had DCIS (with or without invasive cancer) compared with 92 noncarriers (34%). Univariate analysis showed that both DCIS and invasive cancer had an earlier onset in mutation carriers than in noncarriers, although on a per-woman basis, this difference was not statistically significant. High-grade DCIS was more common in BRCA1 mutation carriers than in patients without a mutation (P = .02). Conclusion DCIS is equally as prevalent in patients who carry deleterious BRCA mutations as in high familial-risk women who are noncarriers, but occurs at an earlier age. Our results argue for the consideration of DCIS as a criterion for BRCA risk assessments with appropriate weighting in prediction models such as BRCAPRO.

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