Ductal carcinoma in situ: a review of recent advances.
ABSTRACT This review summarizes recent findings on ductal carcinoma in situ of the breast and their impact on prognosis and management of the disease.
Great advances have been made in our understanding of ductal carcinoma in situ. Nuclear grading is probably the most important pathological factor that affects clinical outcome and correlates with distinct genetic pathways. Identifying key molecules in each pathway may provide better markers for prognostic, predictive and therapeutic purposes. Not all cases of ductal carcinoma in situ will progress to invasive ductal carcinoma, and identifying this subgroup of patients should lead to a reduction of overtreatment. Progenitor cell theory at the cellular level and sick lobe theory at the architectural level may help provide a better understanding of ductal carcinoma in situ from a different perspective and facilitate the development of individualized therapy. Prevention of local recurrence is the primary goal for treatment. Debate continues, however, on the use of radiotherapy, hormonal therapy, and sentinel lymph node biopsy. A panel of molecular markers may be needed for accurately predicting clinical outcome for the disease.
Understanding the carcinogenesis of ductal carcinoma in situ at the molecular level may lead to an optimal individualized therapy with minimal over or undertreatment.
SourceAvailable from: Jeong S Han[Show abstract] [Hide abstract]
ABSTRACT: There is a paucity of data regarding molecular subtypes of pure ductal carcinoma in situ (pDCIS). We evaluated the expression of ER, PR, HER2, Ki67, and p53 and DNA ploidy in 118 pDCIS and 100 invasive breast carcinomas (IBCAs) by routine IHC and classified them according to molecular subtypes. Quantification of biomarkers and DNA ploidy was performed by image analysis. Expression of ER, PR, and high ki67 was more frequent in pDCIS compared to IBCA. High-grade tumors had lower ER and PR expression, high Ki67, overexpression of HER2 and p53, and DNA aneuploidy. Luminal A and HER2 subtypes were more common in pDCIS, and triple negative was more prevalent in IBCA. In both groups, HER2 and triple negative subtypes were characterized by high ki67, overexpression of p53, and DNA aneuploidy compared to luminal subtypes. Molecular subtypes of IBCA are distinct from those of pDCIS. Invasion is characterized by change in phenotype in some tumors.08/2011; 2011:217060. DOI:10.4061/2011/217060
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ABSTRACT: Background and objective To study the behaviour of 18F-FDG-PET in patients with in situ breast carcinomas. Patients and method The study group included 19 women with a tumor size between 0.8 and 2.2 cm. An uptake in breast with a SUV > 1.9 was considered as positive. Results 18F-FDG-PET was positive in 8 patients (SUV; range 0.6-2.8; 1.64 [0.59]) and only when the tumor size was higher than 1 cm. Likewise, only in the PET-positive tumors, an inverse (r = −0.637) and positive (p < 0.05) correlation between SUV and weight of patients was observed. When we compared the results with those obtained in 28 patients having infiltrating ductal carcinomas of the breast, we observed that the 18F-FDG-PET was positive only in tumors > 1 cm also, but the percentages of positives (89%) were higher than those obtained in in-situ carcinoma, regardless of tumor size. Conclusions The percentage of positive results of 18F-FDG-PET in in-situ breast carcinomas and the SUV are lower than those observed in infiltrating ductal carcinomas, regardless of tumor size. Those carcinomas can be a source of false negative results with such imaging technique.Medicina Clínica 03/2008; 130(9):332-333. DOI:10.1157/13117350 · 1.25 Impact Factor
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ABSTRACT: As the field of molecular imaging evolves and increasingly is asked to fill the discovery and validation space between basic science and clinical applications, careful consideration should be given to the models in which studies are conducted. The MIN-O mouse model series is an established in vivo model of human mammary precancer ductal carcinoma in situ with progression to invasive carcinoma. This series of transplant lines is propagated in vivo and experiments utilizing this model can be completed in non-engineered immune intact FVB/n wild type mice thereby modeling the tumor microenvironment with biological relevance superior to traditional tumor cell xenografts. Unfortunately, the same qualities that make this and many other transplant lines more biologically relevant than standard cell lines for molecular imaging studies present a significant obstacle as somatic genetic re-engineering modifications common to many imaging applications can be technically challenging. Here, we describe a protocol for the efficient lentiviral transduction of cell slurries derived from precancerous MIN-O lesions, in vitro culture of "MIN-O-spheres" derived from single cell clones, and the subsequent transplantation of these spheres to produce transduced sublines suitable for optical imaging applications. These lines retain the physiologic and pathologic properties, including multilineage differentiation, and complex microanatomic interaction with the host stroma characteristic of the MIN-O model. We also present the in vivo imaging and immunohistochemical analysis of serial transplantation of one such subline and detail the progressive multifocal loss of the transgene in successive generations.PLoS ONE 06/2012; 7(6):e39350. DOI:10.1371/journal.pone.0039350 · 3.53 Impact Factor