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Different distribution of breast cancer subtypes in breast ductal carcinoma in situ (DCIS), DCIS with microinvasion, and DCIS with invasion component.
Ann Surg Oncol. 2011 May; 18(5):1342-8.AS

Abstract

BACKGROUND

Breast ductal carcinoma in situ with microinvasion (DCIS-Mi) is considered to be the interim stage in the progression from DCIS to invasive breast cancer (IDC). Cases that exceed DCIS-Mi but still do not fulfill the diagnostic criteria of IDC often are observed. We define those cases as DCIS with invasion component (DCIS-I), and attempt to study the differences of clinicopathological features and immunohistochemical-based subtypes among DCIS, DCIS-Mi, and DCIS-I.

METHODS

In this retrospective study, 550 consecutive DCIS patients were recruited, 271 (49.3%) cases were diagnosed as pure-DCIS, 67 as DCIS-Mi, and 212 as DCIS-I. They were categorized into four groups: luminal-A (ER+ and/or PR+, HER2-), luminal-B (ER+ and/or PR+, HER2+), ERBB2+ (ER-, PR-, HER2+), and basal-like (ER-, PR-, HER2-).

RESULTS

DCIS-Mi and DCIS-I patients tended to have larger tumors with highly graded nuclear (P = 0.011 for size; P < 0.0001 for nuclear grade). The proportion of luminal-like tumors decreased, whereas ERBB2+ and basal-like tumors increased in DCIS-I/DCIS-Mi compared with pure-DCIS (P = 0.039). Although the HER2-positive tumors displayed a stable proportion among DCIS subgroups, the essences of them were varying. In pure-DCIS, luminal-B was the major subtype of HER2-positive tumors (luminal-B vs. ERBB2+, 19% vs. 14.6%), whereas in DCIS-I, the proportion of luminal-B decreased vastly (luminal-B vs. ERBB2+, 12.8% vs. 23.5%). DCIS-I had a worse relapse-free survival outcome compared with pure-DCIS.

CONCLUSIONS

Different distribution of subtypes and distinctive characteristics among DCIS, DCIS-Mi, and DCIS-I indicate that they are distinct entities. Further studies with larger sample size are needed to replicate our observations.

Authors+Show Affiliations

Department of Breast Surgery, Fudan University, Shanghai, People's Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21042943

Citation

Yu, Ke-Da, et al. "Different Distribution of Breast Cancer Subtypes in Breast Ductal Carcinoma in Situ (DCIS), DCIS With Microinvasion, and DCIS With Invasion Component." Annals of Surgical Oncology, vol. 18, no. 5, 2011, pp. 1342-8.
Yu KD, Wu LM, Liu GY, et al. Different distribution of breast cancer subtypes in breast ductal carcinoma in situ (DCIS), DCIS with microinvasion, and DCIS with invasion component. Ann Surg Oncol. 2011;18(5):1342-8.
Yu, K. D., Wu, L. M., Liu, G. Y., Wu, J., Di, G. H., Shen, Z. Z., & Shao, Z. M. (2011). Different distribution of breast cancer subtypes in breast ductal carcinoma in situ (DCIS), DCIS with microinvasion, and DCIS with invasion component. Annals of Surgical Oncology, 18(5), 1342-8. https://doi.org/10.1245/s10434-010-1407-3
Yu KD, et al. Different Distribution of Breast Cancer Subtypes in Breast Ductal Carcinoma in Situ (DCIS), DCIS With Microinvasion, and DCIS With Invasion Component. Ann Surg Oncol. 2011;18(5):1342-8. PubMed PMID: 21042943.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Different distribution of breast cancer subtypes in breast ductal carcinoma in situ (DCIS), DCIS with microinvasion, and DCIS with invasion component. AU - Yu,Ke-Da, AU - Wu,La-Mu, AU - Liu,Guang-Yu, AU - Wu,Jiong, AU - Di,Gen-Hong, AU - Shen,Zhen-Zhou, AU - Shao,Zhi-Ming, Y1 - 2010/11/02/ PY - 2009/09/13/received PY - 2010/11/3/entrez PY - 2010/11/3/pubmed PY - 2011/8/31/medline SP - 1342 EP - 8 JF - Annals of surgical oncology JO - Ann Surg Oncol VL - 18 IS - 5 N2 - BACKGROUND: Breast ductal carcinoma in situ with microinvasion (DCIS-Mi) is considered to be the interim stage in the progression from DCIS to invasive breast cancer (IDC). Cases that exceed DCIS-Mi but still do not fulfill the diagnostic criteria of IDC often are observed. We define those cases as DCIS with invasion component (DCIS-I), and attempt to study the differences of clinicopathological features and immunohistochemical-based subtypes among DCIS, DCIS-Mi, and DCIS-I. METHODS: In this retrospective study, 550 consecutive DCIS patients were recruited, 271 (49.3%) cases were diagnosed as pure-DCIS, 67 as DCIS-Mi, and 212 as DCIS-I. They were categorized into four groups: luminal-A (ER+ and/or PR+, HER2-), luminal-B (ER+ and/or PR+, HER2+), ERBB2+ (ER-, PR-, HER2+), and basal-like (ER-, PR-, HER2-). RESULTS: DCIS-Mi and DCIS-I patients tended to have larger tumors with highly graded nuclear (P = 0.011 for size; P < 0.0001 for nuclear grade). The proportion of luminal-like tumors decreased, whereas ERBB2+ and basal-like tumors increased in DCIS-I/DCIS-Mi compared with pure-DCIS (P = 0.039). Although the HER2-positive tumors displayed a stable proportion among DCIS subgroups, the essences of them were varying. In pure-DCIS, luminal-B was the major subtype of HER2-positive tumors (luminal-B vs. ERBB2+, 19% vs. 14.6%), whereas in DCIS-I, the proportion of luminal-B decreased vastly (luminal-B vs. ERBB2+, 12.8% vs. 23.5%). DCIS-I had a worse relapse-free survival outcome compared with pure-DCIS. CONCLUSIONS: Different distribution of subtypes and distinctive characteristics among DCIS, DCIS-Mi, and DCIS-I indicate that they are distinct entities. Further studies with larger sample size are needed to replicate our observations. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/21042943/Different_distribution_of_breast_cancer_subtypes_in_breast_ductal_carcinoma_in_situ__DCIS__DCIS_with_microinvasion_and_DCIS_with_invasion_component_ L2 - https://dx.doi.org/10.1245/s10434-010-1407-3 DB - PRIME DP - Unbound Medicine ER -