Overdiagnosis and Overtreatment of Breast Cancer: Progression of Ductal Carcinoma in Situ: the Pathological Perspective

Overview

Journal Breast Cancer Res

Specialty Oncology

Date 2006 May 9

PMID 16677423

Citations 27

Authors

J Louise Jones

Affiliations

Soon will be listed here.

Abstract

Ductal carcinoma in situ (DCIS) is encountered much more frequently in the screening population compared to the symptomatic setting. The behaviour of DCIS is highly variable and this presents difficulties in choosing appropriate treatment strategies for individual cases. This review discusses the current data on the frequency and rate of progression of DCIS, the value and limitations of clinicopathological and biological variables in predicting disease behaviour and suggests strategies to develop more robust means of predicting progression of DCIS.

Citing Articles

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Clinical Proteomics Reveals Vulnerabilities in Noninvasive Breast Ductal Carcinoma and Drives Personalized Treatment Strategies.

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Low progesterone receptor levels in high-grade DCIS correlate with HER2 upregulation and the presence of invasive components.

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References

van Dongen J, Holland R, Peterse J, Fentiman I, LAGIOS M, Millis R . Ductal carcinoma in-situ of the breast; second EORTC consensus meeting. Eur J Cancer. 1992; 28(2-3):626-9. DOI: 10.1016/s0959-8049(05)80113-3. View

Cornfield D, Palazzo J, Schwartz G, Goonewardene S, Kovatich A, Chervoneva I . The prognostic significance of multiple morphologic features and biologic markers in ductal carcinoma in situ of the breast: a study of a large cohort of patients treated with surgery alone. Cancer. 2004; 100(11):2317-27. DOI: 10.1002/cncr.20260. View

Allinen M, Beroukhim R, Cai L, Brennan C, Lahti-Domenici J, Huang H . Molecular characterization of the tumor microenvironment in breast cancer. Cancer Cell. 2004; 6(1):17-32. DOI: 10.1016/j.ccr.2004.06.010. View

Skinner K, Silverstein M . The management of ductal carcinoma in situ of the breast. Endocr Relat Cancer. 2001; 8(1):33-45. DOI: 10.1677/erc.0.0080033. View

Schnitt S . The diagnosis and management of pre-invasive breast disease: flat epithelial atypia--classification, pathologic features and clinical significance. Breast Cancer Res. 2003; 5(5):263-8. PMC: 314429. DOI: 10.1186/bcr625. View

Ringberg A, Anagnostaki L, Anderson H, Idvall I, Ferno M . Cell biological factors in ductal carcinoma in situ (DCIS) of the breast-relationship to ipsilateral local recurrence and histopathological characteristics. Eur J Cancer. 2001; 37(12):1514-22. DOI: 10.1016/s0959-8049(01)00165-4. View

Millis R, Ryder K, Fentiman I . Ductal in situ component and prognosis in invasive mammary carcinoma. Breast Cancer Res Treat. 2004; 84(2):197-8. DOI: 10.1023/B:BREA.0000018434.04960.02. View

Sanders M, Schuyler P, Dupont W, Page D . The natural history of low-grade ductal carcinoma in situ of the breast in women treated by biopsy only revealed over 30 years of long-term follow-up. Cancer. 2005; 103(12):2481-4. DOI: 10.1002/cncr.21069. View

Sartor C, Zhou H, Kozlowska E, Guttridge K, Kawata E, Caskey L . Her4 mediates ligand-dependent antiproliferative and differentiation responses in human breast cancer cells. Mol Cell Biol. 2001; 21(13):4265-75. PMC: 87087. DOI: 10.1128/MCB.21.13.4265-4275.2001. View

10.

Bijker N, Peterse J, Duchateau L, Julien J, Fentiman I, Duval C . Risk factors for recurrence and metastasis after breast-conserving therapy for ductal carcinoma-in-situ: analysis of European Organization for Research and Treatment of Cancer Trial 10853. J Clin Oncol. 2001; 19(8):2263-71. DOI: 10.1200/JCO.2001.19.8.2263. View

11.

van Dongen J, Fentiman I, Harris J, Holland R, Peterse J, Salvadori B . In-situ breast cancer: the EORTC consensus meeting. Lancet. 1989; 2(8653):25-7. DOI: 10.1016/s0140-6736(89)90263-8. View

12.

Nielsen B, Rank F, Lopez J, Balbin M, Vizoso F, Lund L . Collagenase-3 expression in breast myofibroblasts as a molecular marker of transition of ductal carcinoma in situ lesions to invasive ductal carcinomas. Cancer Res. 2001; 61(19):7091-100. View

13.

Barnes N, Khavari S, Boland G, Cramer A, Knox W, Bundred N . Absence of HER4 expression predicts recurrence of ductal carcinoma in situ of the breast. Clin Cancer Res. 2005; 11(6):2163-8. DOI: 10.1158/1078-0432.CCR-04-1633. View

14.

Ma X, Salunga R, Tuggle J, Gaudet J, Enright E, McQuary P . Gene expression profiles of human breast cancer progression. Proc Natl Acad Sci U S A. 2003; 100(10):5974-9. PMC: 156311. DOI: 10.1073/pnas.0931261100. View

15.

Betsill Jr W, Rosen P, Lieberman P, ROBBINS G . Intraductal carcinoma. Long-term follow-up after treatment by biopsy alone. JAMA. 1978; 239(18):1863-7. DOI: 10.1001/jama.239.18.1863. View

16.

Weigelt B, Wessels L, Bosma A, Glas A, Nuyten D, He Y . No common denominator for breast cancer lymph node metastasis. Br J Cancer. 2005; 93(8):924-32. PMC: 2361648. DOI: 10.1038/sj.bjc.6602794. View

17.

Eusebi V, Feudale E, Foschini M, Micheli A, Conti A, Riva C . Long-term follow-up of in situ carcinoma of the breast. Semin Diagn Pathol. 1994; 11(3):223-35. View

18.

Silverstein M, LAGIOS M, CRAIG P, Waisman J, Lewinsky B, Colburn W . A prognostic index for ductal carcinoma in situ of the breast. Cancer. 1996; 77(11):2267-74. DOI: 10.1002/(SICI)1097-0142(19960601)77:11<2267::AID-CNCR13>3.0.CO;2-V. View

19.

Ernster V, Barclay J, Kerlikowske K, Wilkie H, Ballard-Barbash R . Mortality among women with ductal carcinoma in situ of the breast in the population-based surveillance, epidemiology and end results program. Arch Intern Med. 2000; 160(7):953-8. DOI: 10.1001/archinte.160.7.953. View

20.

Badve S, AHern R, Ward A, Millis R, Pinder S, Ellis I . Prediction of local recurrence of ductal carcinoma in situ of the breast using five histological classifications: a comparative study with long follow-up. Hum Pathol. 1998; 29(9):915-23. DOI: 10.1016/s0046-8177(98)90196-4. View