Predicting relapse in ductal carcinoma in situ patients: an analysis of biologic markers with long-term follow-up

Abstract Background The incidence of ductal carcinoma in situ (DCIS) of the breast is increasing. Optimal treatment remains controversial and, because of a long natural history, may not be evident for many years. We undertook this study to identify markers of disease recurrence. Methods We studied 1...

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Bibliographic Details
Published in:The American journal of surgery 2007-10, Vol.194 (4), p.504-506
Main Authors: Hieken, Tina J., M.D, Cheregi, John, M.S, Farolan, Miguel, M.D, Kim, Joan, B.A, Velasco, Josè M., M.D
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Angiogenic factors
Biologic markers
Biological and medical sciences
Breast cancer
Breast Neoplasms - chemistry
Breast Neoplasms - metabolism
Breast Neoplasms - pathology
Carcinoma, Intraductal, Noninfiltrating - chemistry
Carcinoma, Intraductal, Noninfiltrating - metabolism
Carcinoma, Intraductal, Noninfiltrating - pathology
Ductal carcinoma in situ of the breast
Follow-Up Studies
General aspects
Gynecology. Andrology. Obstetrics
Humans
Long-term follow-up
Mammary gland diseases
Mammography
Mastectomy
Medical sciences
Middle Aged
p53
Predictive Value of Tests
Recurrence
Surgery
Time Factors
Tumor Suppressor Protein p53 - analysis
Tumor Suppressor Protein p53 - biosynthesis
Tumors
Vascular endothelial growth factor
Vascular Endothelial Growth Factor A - analysis
Vascular Endothelial Growth Factor A - biosynthesis
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Summary:Abstract Background The incidence of ductal carcinoma in situ (DCIS) of the breast is increasing. Optimal treatment remains controversial and, because of a long natural history, may not be evident for many years. We undertook this study to identify markers of disease recurrence. Methods We studied 131 pure DCIS patients with a 100-month mean follow-up. We performed a complete histologic review, immunohistochemical staining for p53 and vascular endothelial growth factor expression, and enumerated microvessel density/mm2 using factor VIII-Ab. Statistical analysis was performed by using an SAS software package (Cary, NC). Results Eleven patients (8%) developed ipsilateral recurrence at a mean of 55 months (11–137 months) after initial treatment. Three were DCIS, and 8 were invasive cancer. Recurrence was significantly predicted by p53 overexpression (in 55% of tumors that recurred versus 22% of those that did not, P = .02) but not other factors. Conclusions These data suggest that biologic factors may have an important role in predicting recurrence in DCIS patients.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.07.002