MedWorm: DCIS (Ductal Carcinoma in Situ)

Prospective Multicenter Cohort Study to Refine Management Recommendations for Women at Elevated Familial Risk of Breast Cancer: The EVA Trial [Breast Cancer]

Journal of Clinical Oncology — Thu, 18 Mar 2010 22:01:36 +0100

Conclusion In women at elevated familial risk, quality-assured MRI screening shifts the distribution of screen-detected breast cancers toward the preinvasive stage. In women undergoing quality-assured MRI annually, neither mammography, nor annual or half-yearly ultrasound or CBE will add to the cancer yield achieved by MRI alone. (Source: Journal of Clinical Oncology)

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p63 short isoforms are found in invasive carcinomas only and not in benign breast conditions

Virchows Archiv — Thu, 11 Mar 2010 18:12:45 +0100

Abstract Two N-terminal isoforms characterize the p63 protein: the transactivating isoform TAp63 and the amino-terminal truncated isoform ΔNp63. Two further N-terminal isoforms lacking exon 4 (d4TAp63 and ΔNp73L) have been reported. Purpose of the study was to investigate the molecular expression of N-terminal p63 isoforms in benign and malignant breast tissues. Eighteen randomly selected cases of invasive breast carcinoma (IBC) of luminal type, two cases of in situ duct carcinoma (DCIS/DIN), and 20 specimens of normal and benign breast tissues were studied. All cases were immunostained for p63. Reverse polymerase chain reaction and nested PCR were performed to evaluate p63 N-terminal expression patterns. These isoforms whenever present were validated by sequencing. All ...

Is there a Role for MRI in the Preoperative Assessment of Patients with DCIS?

Annals of Surgical Oncology — Wed, 10 Mar 2010 16:00:55 +0100

Conclusions MRI does not accurately predict extent of disease in patients with extensive DCIS. In patients with MRI tumor size ≤2 cm, MRI may assist in surgical planning. MRI results in patients with DCIS should be interpreted with caution; decision for mastectomy should not be made on MRI findings alone. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-010-1000-9Authors Lisa R. Allen, Drexel University College of Medicine Department of Surgery Philadelphia PA USAClaudia E. Lago-Toro, The Bryn Mawr Hospital Department of Breast Surgery Bryn Mawr PA USAJenevieve H. Hughes, The Bryn Mawr Hospital Department of Breast Surgery Bryn Mawr PA USAEduardo Careaga, The Bryn Mawr Hospital Department of Breast Surgery Bryn Mawr PA USAAnjeanette T. B...

Loss of ICAM-1 signaling induces psoriasin (S100A7) and MUC1 in mammary epithelial cells

Breast Cancer Research and Treatment — Wed, 10 Mar 2010 13:17:34 +0100

Abstract Psoriasin (S100A7), a member of the S100 gene family, is highly expressed in high-grade comedo ductal carcinoma in situ (DCIS), with a higher risk of local recurrence. Psoriasin is, therefore, a potential biomarker for DCIS with a poor prognosis. High-grade DCIS is characterized by a high proliferation rate and crowded cells, consequently, lose contact with the extracellular matrix. The aim of this study was, therefore, to elucidate the involvement of adhesion signals in the regulation of psoriasin. Protein expression was evaluated by Western blotting, flow cytometry, and immunohistochemistry, and using breast carcinoma SAGE databases available from the CGAP website. Intercellular adhesion molecule 1 (ICAM-1) was down-regulated in MCF10A cells using short hairpin ...

Expression of HAb18G is associated with tumor progression and prognosis of breast carcinoma

Breast Cancer Research and Treatment — Wed, 10 Mar 2010 13:17:30 +0100

In conclusion, this study suggests that HAb18G expression is associated with BC progression and prognosis. Further evaluation of this new marker in breast cancer is indicated. Content Type Journal ArticleCategory Preclinical studyDOI 10.1007/s10549-010-0790-6Authors Fangfang Liu, Cancer Hospital of Tianjin Medical University Department of Breast Cancer Pathology and Research Laboratory, State Key Laboratory of Breast Cancer Research Tianjin 300060 ChinaLifang Cui, Cancer Hospital of Tianjin Medical University Department of Breast Cancer Pathology and Research Laboratory, State Key Laboratory of Breast Cancer Research Tianjin 300060 ChinaYang Zhang, Fourth Military Medical University Cell Engineering Research Centre & Department of Cell Biology, State Key Laboratory of Cancer Biolo...

Neuroendocrine ductal carcinoma in situ of the breast: cytological features in 32 cases

Cytopathology — Fri, 05 Mar 2010 00:00:00 +0100

Conclusions: NE-DCIS has distinctive cytological features and can therefore be diagnosed as a neuroendocrine tumour in most FNAs and some nipple discharge smears by cytological examination employing immunohistochemical techniques. We emphasize that a breast lesion with these features may be in situ and not invasive, and also that there is a risk of under-diagnosis. (Source: Cytopathology)

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Ductal Carcinoma In Situ of the Breast: A Systematic Review of Incidence, Treatment, and Outcomes

Medscape Radiology Headlines — Tue, 02 Mar 2010 16:38:35 +0100

How have DCIS rates changed and what factors influence incidence rates over time? Journal of the National Cancer Institute (Source: Medscape Radiology Headlines)

The Adjacent Vessel Sign on Breast MRI: New Data and a Subgroup Analysis for 1,084 Histologically Verified Cases.

Korean J Radiol — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: The adjacent vessel sign was significantly associated with malignancy. Thus, it can be used to accurately assess breast lesions on bMRI. In this study, the AVS was particularly associated with advanced and invasive carcinomas. PMID: 20191065 [PubMed - in process] (Source: Korean J Radiol)

Differential diagnosis of mammographically and clinically occult breast lesions on diffusion-weighted MRI

Journal of Magnetic Resonance Imaging — Thu, 25 Feb 2010 00:00:00 +0100

To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for mammographically and clinically occult breast lesions.The study included 91 women with 118 breast lesions (91 benign, 12 ductal carcinoma in situ [DCIS], 15 invasive carcinoma) initially detected on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and assigned BI-RADS category 3, 4, or 5. DWI was acquired with b = 0 and 600 s/mm2. Lesion visibility was assessed on DWI. Apparent diffusion coefficient (ADC) values were compared between malignancies, benign lesions, and normal (no abnormal enhancement on DCE-MRI) breast tissue, and the diagnostic performance of DWI was assessed based on ADC thresholding.Twenty-four of 27 (89%) malignant and 74/91 (81%) benign lesions were hyperintense on the b = 60...

Cyclooxygenase-2 Inhibition Does Not Improve the Reduction in Ductal Carcinoma In situ Proliferation with Aromatase Inhibitor Therapy: Results of the ERISAC Randomized Placebo-Controlled Trial.

Clinical Breast Cancer — Tue, 23 Feb 2010 00:00:00 +0100

CONCLUSIONS: Exemestane reduces proliferation in ER-positive DCIS. Aromatase inhibition is a potential alternative to tamoxifen in patients who have undergone breast conservation for ER-positive DCIS. Clin Cancer Res; 16(5); 1605-12. PMID: 20179229 [PubMed - as supplied by publisher] (Source: Clinical Breast Cancer)

Cancerous Breast Lesions on Dynamic Contrast-enhanced MR Images: Computerized Characterization for Image-based Prognostic Markers [BREAST IMAGING]

Radiology — Mon, 22 Feb 2010 20:50:30 +0100

Study results show that our MR imaging computer-aided diagnosis algorithm, with use of a combination of computer-extracted MR imaging kinetic and morphologic features, has the potential to be extended to two prognostic tasks: (a) classification of noninvasive (ductal carcinoma in situ) versus invasive (invasive ductal carcinoma [IDC]) lesions and (b) further classification of IDC lesions into lesions with positive lymph nodes (LNs) and lesions with negative LNs. (Source: Radiology)

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Expression of Vascular Notch Ligand Delta-Like 4 and Inflammatory Markers in Breast Cancer.

The American Journal of Pathology — Thu, 18 Feb 2010 00:00:00 +0100

We examined 296 breast adenocarcinomas and 38 ductal carcinoma in situ tissues that were represented in tissue microarrays. Additional whole sections representing 10 breast adenocarcinomas, 10 normal breast tissues, and 16 angiosarcomas were included. Immunohistochemistry was then performed by using validated antibodies against Dll4, CD68, CD14, DC-SIGN, CD123, neutrophil elastase, CD31, and carbonic anhydrase 9. Dll4 was selectively expressed by intratumoral endothelial cells in 73% to 100% of breast adenocarcinomas, 18% of in situ ductal carcinomas, and all lactating breast cases, but not normal nonlactating breast. High intensity of endothelial Dll4 expression was a statistically significant adverse prognostic factor in univariate (P = 0.002 and P = 0.01) and multivariate analyses (P = ...

[Ductal carcinoma in situ of the breast (DCIS). Histopathological features and treatment modalities: analysis of 1,289 cases.]

Bulletin du Cancer — Tue, 16 Feb 2010 00:00:00 +0100

Authors: Cutuli B, Lemanski C, Fourquet A, de Lafontan B, Giard S, Lancrenon S, Meunier A, Pioud-Martigny R, Campana F, Marsiglia H, Mery E, Penault-Llorca F, Fondrinier E, Tunon de Lara C From March 2003 to April 2004, were prospectively collected in France 1,289 ductal carcinoma in situ (DCIS) with data on diagnosis, patient and tumour characteristics, and treatments. Median age was 56 years (range, 30-84). DCIS was diagnosed by mammography in 87.6% of patients. Mastectomy (M), conservative surgery alone (CS) and conservative surgery with radiotherapy (CS + RT) were performed in 30.5, 7.8 and 61.7% of patients, respectively. Sentinel node biopsy (SNB) and axillary dissection (AD) were performed in 21.3 and 10.4% of patients, respectively. Hormone therapy was administered to 13.4% of ...

DCIS and the Power of Words

Medscape Today Headlines — Fri, 12 Feb 2010 22:10:28 +0100

The word carcinoma impacts how patients and physicians think about ductal carcinoma in situ. Dr. Kathy Miller considers whether a change in name could influence a change in practice. Medscape Hematology-Oncology (Source: Medscape Today Headlines)

Number of lymph nodes removed in sentinel lymph node-negative breast cancer patients is significantly related to patient age and tumor size

Cancer — Thu, 11 Feb 2010 00:00:00 +0100

Sentinel lymph node (SLN) biopsy has been well-established for axillary lymph node staging for patients with breast cancer. For lymph node-negative patients, planned "backup" axillary lymph node dissection (ALND) is rarely indicated. Among patients with negative SLNs, the authors observed variation by tumor size and patient age in the total number of lymph nodes removed (SLNs plus non-SLNs). They hypothesized that this variation is an unrecognized source of bias for studies examining the morbidity of SLN biopsy.Retrospective review of this institution's SLN database identified 4103 SLN biopsy procedures between 1997 and 2004 in which SLN biopsy was performed for prophylactic mastectomy, ductal carcinoma in situ, or T1 to T2 invasive cancers, and the SLNs were benign.The mean number of SLNs...

Following DCIS Diagnosis, Psychosicail Interventions Recommended

Dermatology News From Medical News Today — Tue, 09 Feb 2010 11:00:00 +0100

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Following DCIS Diagnosis, Psychosicail Interventions Recommended

Health News from Medical News Today — Tue, 09 Feb 2010 11:00:00 +0100

A new analysis has found that women with medium or low levels of income are particularly susceptible to anxiety and depression after being diagnosed with the precancerous breast condition, ductal carcinoma in situ (DCIS). Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the study suggests that women with financial hardship may benefit from psychosocial interventions that are designed to accommodate their unique needs... (Source: Health News from Medical News Today)

Breast density, scintimammographic (99m)Tc(V)DMSA uptake, and calcitonin gene related peptide (CGRP) expression in mixed invasive ductal associated with extensive in situ ductal carcinoma (IDC + DCIS) and pure invasive ductal carcinoma (IDC): correlation with estrogen receptor (ER) status, proliferation index Ki-67, and histological grade.

Breast Cancer — Tue, 09 Feb 2010 00:00:00 +0100

CONCLUSIONS: BetaD, SMM, CGRP, and Ki-67 were significantly increased, whereas ER was significantly decreased, in IDC + DCIS as compared with IDC, indicating that IDC + DCIS is an entity that is more aggressive, ER independent, and possibly associated with a pathway linked to stromal involvement and CGRP activity. PMID: 20143189 [PubMed - as supplied by publisher] (Source: Breast Cancer)

Financial hardship and anxiety

Medicineworld.org: New Article Alert — Mon, 08 Feb 2010 14:04:47 +0100

A new analysis has observed that women with medium or low levels of income are especially susceptible to anxiety and depression after being diagnosed with the premalignant breast condition, ductal carcinoma in situ (DCIS). Published early online in Cancer, a peer-evaluated journal of the American Cancer Society, the study suggests that women with financial hardship appears to benefit from psychosocial interventions that are designed to accommodate their unique needs........ (Source: Medicineworld.org: New Article Alert)

Financial status associated with anxiety and depression in women with DCIS

HemOncToday.com — Mon, 08 Feb 2010 12:02:00 +0100

(Source: HemOncToday.com)

Financial hardship contributes to diagnosis anxiety

EurekAlert! - Social and Behavioral Science — Mon, 08 Feb 2010 05:00:00 +0100

(American Cancer Society) Women with medium or low levels of income are more susceptible to anxiety and depression after ductal carcinoma in situ diagnosis. (Source: EurekAlert! - Social and Behavioral Science)

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Financial hardship contributes to diagnosis anxiety

ScienceDaily Headlines — Mon, 08 Feb 2010 05:00:00 +0100

Women with medium or low levels of income are more susceptible to anxiety and depression after ductal carcinoma in situ diagnosis. (Source: ScienceDaily Headlines)

The role of socioeconomic status in adjustment after ductal carcinoma in situ

Cancer — Mon, 08 Feb 2010 00:00:00 +0100

This study also explored whether social support explained the association between SES and distress and whether social support buffered the impact of low SES on distress.A total of 487 women with newly diagnosed DCIS were enrolled in the study. Participants completed questions about sociodemographic, psychosocial, and clinical characteristics at the time of enrollment and 9 months after their diagnosis.Financial status was inversely associated with anxiety and depression at the 9-month follow-up. Financial status also predicted change in anxiety and depression. Women with high financial status reported a decline in anxiety and depression during the study period, whereas women with medium or low financial status reported an increase in anxiety and depression. In addition, the probability of ...

Diagnostic value of vacuum-assisted breast biopsy for breast carcinoma: a meta-analysis and systematic review

Breast Cancer Research and Treatment — Wed, 03 Feb 2010 17:58:00 +0100

Abstract As mammography screening has its limitation in diagnosis in breast carcinoma, minimally invasive procedures offer a better option. We conducted a systematic review to establish the overall value of Vacuum-assisted breast biopsy (VAB) for the diagnosis of breast cancer. After a review and quality assessment of 21 studies, sensitivity, specificity and other measures of accuracy of VAB for evaluating breast lesions were pooled using random-effects models. Summary receiver operating characteristic curves were used to summarize overall accuracy. Underestimate rate of atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) were also calculated. The summary estimates for VAB in diagnosis of breast carcinoma were as follows: sensitivity, 0.981 (95% confidenc...

Lesion size is a major determinant of the mammographic features of ductal carcinoma in situ: findings from the Sloane project

Clinical Radiology — Wed, 03 Feb 2010 15:36:27 +0100

Aim: To assess the radiological features of calcific ductal carcinoma in situ (DCIS) in a large, multicentre dataset according to grade and size, and to investigate the possibility that DCIS has different mammographic features when small.Materials and methods: The dataset consisted of all Sloane Project DCIS cases where calcification was present mammographically and histological grade and size were available. The radiology data form classifies calcific DCIS as casting/linear, granular/irregular, or punctate. The pathology dataset includes cytonuclear grade and microscopic tumour size. Correlations were sought between the radiological findings and DCIS grade and size. The significance of differences was assessed using the chi-square test and chi-square test for trend.Results: One thousand, ...

Vasohibin-1 as a potential predictor of aggressive behavior of ductal carcinoma in situ of the breast

Cancer Science — Wed, 03 Feb 2010 00:00:00 +0100

In this study, we first evaluated mRNA expression of vasohibin-1 and CD31 in 39 Japanese female breast carcinoma specimens including 22 invasive ductal carcinoma (IDC) and 17 ductal carcinoma in situ (DCIS) using a real-time quantitative RT-PCR (QRT-PCR) with LightCycler system. In addition, we also immunolocalized vasohibin-1 and CD31 and compared their immunoreactivity to nuclear grades and histological grades of 100 carcinoma cases (50 IDC and 50 DCIS). There were no statistically significant differences of CD31 mRNA expression and the number of CD31 positive vessels between DCIS and IDC (P = 0.250 and P = 0.191, respectively), whereas there was a statistically significant difference in vasohibin-1 mRNA expression and the number of vasohibin-1 positive vessels in DCIS and IDC (P = 0.022...

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Vasohibin-1 as a potential predictor of aggressive behavior of ductal carcinoma in situ of the breast

Cancer Science — Wed, 03 Feb 2010 00:00:00 +0100

National Institutes of Health State-of-the-Science Conference Statement: Diagnosis and Management of Ductal Carcinoma In Situ September 22-24, 2009

JNCI — Tue, 02 Feb 2010 21:01:32 +0100

Conclusions Clearly, the diagnosis and management of DCIS is highly complex with many unanswered questions, including the fundamental natural history of untreated disease. Because of the noninvasive nature of DCIS, coupled with its favorable prognosis, strong consideration should be given to elimination of the use of the anxiety-producing term "carcinoma" from the description of DCIS. The outcomes in women treated with available therapies are excellent. Thus, the primary question for future research must focus on the accurate identification of patient subsets diagnosed with DCIS, including those persons who may be managed with less therapeutic intervention without sacrificing the excellent outcomes presently achieved. Essential in this quest will be the development and validation of accura...

Ductal Carcinoma In Situ of the Breast: A Systematic Review of Incidence, Treatment, and Outcomes

JNCI — Tue, 02 Feb 2010 21:01:32 +0100

Conclusions Scientific questions deserving further investigation include the relationship between mammography use and DCIS incidence and whether imaging technologies and treatment guidelines can be modified to focus on lesions that are most likely to become clinically problematic. (Source: JNCI)

Researchers Tackle Ductal Carcinoma in Situ and Its Many Unanswered Questions

JNCI — Tue, 02 Feb 2010 21:01:31 +0100

(Source: JNCI)

Expression of metalloproteases and their inhibitors by tumor and stromal cells in ductal carcinoma in situ of the breast and their relationship with microinvasive events

Journal of Cancer Research and Clinical Oncology — Tue, 02 Feb 2010 17:48:18 +0100

Conclusions There are significant differences in the expression of MMPs and TIMPs, so in tumor cells and stromal cells, between pure DCIS and DCIS with microinvasive foci. Therefore, these staining patterns might display potential applications as biological markers, such as in evaluating microinvasion in resection specimens of breast tumors. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00432-010-0782-2Authors L. O. González, Unidad de Investigación, Hospital de Jove Avda. Eduardo Castro s/n 33920 Gijón Asturias SpainS. González-Reyes, Unidad de Investigación, Hospital de Jove Avda. Eduardo Castro s/n 33920 Gijón Asturias SpainS. Junquera, Unidad de Investigación, Hospital de Jove Avda. Eduardo Castro s/n 33920 Gijón Asturias SpainL. Marín, ...

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Cancerous Breast Lesions on Dynamic Contrast-enhanced MR Images: Computerized Characterization for Image-based Prognostic Markers [BREAST IMAGING]

Continuous Publishing articles — Mon, 01 Feb 2010 14:54:27 +0100

Clinicopathologic factors associated with involved margins after breast-conserving surgery for invasive lobular carcinoma.

Clinical Genitourinary Cancer — Mon, 01 Feb 2010 00:00:00 +0100

Conclusion: Core needle biopsy is the preferred method of diagnostic biopsy before surgical intervention. With appropriate patient selection, most patients with early-stage ILC can undergo successful BCS. PMID: 20133259 [PubMed - in process] (Source: Clinical Genitourinary Cancer)

Papilloma and papillary carcinoma

Seminars in Diagnostic Pathology — Mon, 01 Feb 2010 00:00:00 +0100

Papillomas and papillary carcinomas differ in their 3 fundamental characteristics: the geometric properties of their fronds, the amount of their stroma, and the characteristics of their epithelium. Fibrosis at the edge of papillomas often entraps glands and creates the spurious impression of invasion. The proliferation of surface epithelial cells of papillomas does not give rise to unexpected diagnostic difficulties, but glandular proliferation within the stalks of papillomas often simulates the appearance of cribriform ductal carcinoma in situ. Needle biopsies of papillomas can deposit clusters of benign cells in a distribution that resembles an invasive carcinoma. Although papillomas overrun by ductal carcinoma in situ exhibit a papillary architecture, other features differentiate them f...

Clinging carcinoma: an American perspective

Seminars in Diagnostic Pathology — Mon, 01 Feb 2010 00:00:00 +0100

In 1979, Professor John Azzopardi introduced the term “clinging carcinoma” to describe what he considered to represent examples of ductal carcinoma in-situ (DCIS) characterized by “neoplastic cells…limited to the periphery of the containing structures.” He emphasized that these lesions can be easily missed “since the alteration is cytological rather than anatomical.” Two types of clinging carcinoma were described by Azzopardi. He considered the first to represent a variant of high-grade DCIS, and most pathologists concur with that view. In contrast, pathologists have been much more reluctant to accept Azzopardi's second type of clinging carcinoma as a type of DCIS, particularly in the United States. This second type is characterized by cells with low grade, monomorphic-type c...

Flat ductal intraepithelial neoplasia of the breast: evolution of Azzopardi's “clinging” concept

Seminars in Diagnostic Pathology — Mon, 01 Feb 2010 00:00:00 +0100

Thirty years ago, John G. Azzopardi described a mainly cytologically defined atypical intraepithelial lesion of the breast, which he called “clinging carcinoma in situ,” a variant of “ductal carcinoma in situ.” The lesion was characterized by replacement of native epithelial cells by very few cell layers of mildly to severely atypical epithelial cells. Based on the degree of cytologic atypia, Azzopardi distinguished type 1 with highly atypical nuclei and type 2 with merely subtle cytologic (nuclear) atypia. Although this distinctive lesion remained widely unrecognized and/or ignored by many pathologists for a long period, several recent studies strongly suggest its neoplastic nature. The aim of this review is to focus on the “clinging” concept and its evolution after the first ...

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Chromosomal Alterations in Pure Nonneoplastic Breast Lesions: Implications for Breast Cancer Progression

Annals of Surgical Oncology — Wed, 27 Jan 2010 19:58:36 +0100

Conclusions Pure CCL and ADH lesions demonstrate lower levels of genetic alterations than DCIS, invasive carcinomas or CCL/ADH lesions from cancerous breasts; alterations of chromosomes 16q and 17p were not detected. Pure CCL and ADH lesions are not genetically advanced, and molecular profiles do not support these lesions as obligatory precursors to more advanced disease. Molecular differences between pure and synchronous lesions support re-evaluation of current models of disease initiation, progression, and risk. Content Type Journal ArticleCategory Translational Research and BiomarkersDOI 10.1245/s10434-010-0910-xAuthors Rachel E. Ellsworth, Henry M. Jackson Foundation for the Advancement of Military Medicine Clinical Breast Care Project Windber PA USADarrell L. E...

Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer

World Journal of Surgical Oncology — Wed, 27 Jan 2010 00:00:00 +0100

Background: The impact of sentinel lymph node biopsy on breast cancer mimicking ductal carcinoma in situ (DCIS) is a matter of debate. Methods: We studied the rate of occurrence of sentinel lymph node metastasis in 255 breast cancer patients with pure DCIS showing no invasive components on routine pathological examination. We compared this to the rate of occurrence in 177 patients with predominant intraductal-component (IDC) breast cancers containing invasive foci equal to or less than 0.5 cm in size. Results: Most of the clinical and pathological baseline characteristics were the same between the two groups. However, peritumoral lymphatic permeation occurred less often in the pure DCIS group than in the IDC-predominant invasive-lesion group (1.2% vs. 6.8%, p=0.002). One patient (0.39%) wi...

DCIS size underestimated in third of cases

MedWire News - Oncology — Wed, 27 Jan 2010 00:00:00 +0100

UK study results show that pre-operative imaging underestimates the extent of disease in a third of patients undergoing breast-conserving surgery for ductal carcinoma in situ, resulting in a need for further surgery in these patients. (Source: MedWire News - Oncology)

DCIS size underestimated in third of cases

MedWire News - Breast Cancer — Wed, 27 Jan 2010 00:00:00 +0100

Tamoxifen Malabsorption After Roux-en-Y Gastric Bypass Surgery: Case Series and Review of the Literature

Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy — Tue, 26 Jan 2010 00:00:00 +0100

Pharmacotherapy 30(2): 217-217 Abstract Roux-en-Y gastric bypass is a gastric reduction duodenal switch with a combination of restrictive and malabsorptive procedures. It is the most common gastric bypass procedure performed in the United States. Malabsorption causing nutritional deficiencies does occur, yet a PubMed literature search (1955-2009) returned no reports of malabsorption of anticancer agents after gastric bypass. To our knowledge, this is the first report of three cases of malabsorption of the anticancer agent tamoxifen after this procedure. The first patient was a 58-year-old woman who underwent Roux-en-Y bypass for morbid obesity. Two years later, she developed estrogen receptor-positive ductal carcinoma in situ of the breast, underwent lumpectomy and irradiation, and tamoxif...

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Heterogeneity for Stem Cell-Related Markers According to Tumor Subtype and Histologic Stage in Breast Cancer.

Clinical Cancer Research — Tue, 26 Jan 2010 00:00:00 +0100

CONCLUSIONS: Our findings suggest that in breast cancer, the frequency of tumor cells positive for stem cell-like and more differentiated cell markers varies according to tumor subtype and histologic stage. Clin Cancer Res; 16(3); 876-87. PMID: 20103682 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

Factors Influencing Reconstruction after Bilateral Mastectomy

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:52 +0100

Introduction: Few studies have been conducted to determine what influences whether or not breast cancer patients who undergo bilateral mastectomy opt for reconstruction. The purpose of this study was to examine potential clinicopathologic factors that play a role in this decision-making process. Methods: We reviewed data from all breast cancer patients who underwent bilateral mastectomies at our institution from 2003 to 2008. Charts were reviewed to determine demographic, clinical and pathologic information at time of mastectomy and reconstruction status. Statistical analyses were performed using SPSS. Results: From 2003-2008, 112 patients underwent bilateral mastectomies at our institution. Of these, 7 (6.3%) had no malignancy in either breast, 14 (12.5%) had either DCIS or LCIS, 74 (66.1...

Sentinel Lymph Node Biopsy May Not Be Necessary in All Patients Undergoing Prophylactic Mastectomy But Should Be Considered in Patients with Inflammatory Breast Cancer and/or Extensive Ipsilateral Axillary Disease

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:51 +0100

Conclusion: The incidence of occult malignancy in the setting of contralateral mastectomy is low (2%), and this may call into question the need for routine sentinel node biopsy in all patients undergoing this procedure. However, patients with ipsilateral inflammatory breast cancer and/or extensive axillary disease are at higher risk of having contralateral malignancy, and sentinel lymph node biopsy may be warranted on the prophylactic side in these patients. (Source: Journal of Surgical Research)

The Impact of Routine Pretreatment Magnetic Resonance Imaging on the Surgical Planning and Outcome in Newly Diagnosed Breast Cancer Patients

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:33 +0100

In this study, we have critically assessed our routine use of pretreatment MRI on surgical planning and outcome. Methods: A retrospective review of our prospectively collected database of all new breast cancer patients seen in our multi-disciplinary breast cancer clinic (BC4) since 2007 was undertaken. The database includes demographic, pathologic, treatment and outcome parameters. In the past 2 years, 157 newly diagnosed breast cancer patients were seen in BC4 that received all of their pretreatment imaging at our institution. Approximately midway through this period, we implemented the routine use of pretreatment of MRI. No other significant alterations were made in our evaluation and treatment (per NCCN guidelines) of these patients during this period. Results: Of the 157 patients, 71 (...

The Use of Breast MRI Surveillance in Women with Prior Curative-Intent Therapy for Breast Cancer

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:33 +0100

Conclusion: Prospective studies are needed to determine which patients would potentially benefit from breast MRI surveillance following curative-intent treatment. The lack of standardized guidelines may result in excessive or inappropriate use, unnecessary follow-up procedures, and a concomitant low yield. (Source: Journal of Surgical Research)

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Histology after lumpectomy in women with epithelial atypia on stereotactic vacuum-assisted breast biopsy

European Journal of Surgical Oncology — Fri, 22 Jan 2010 13:47:57 +0100

Conclusion: ADH diagnosed by vacuum-assisted breast biopsy frequently corresponds to cancer on open surgical biopsy. Surgical excision of all breast lesions containing atypical hyperplasia on percutaneous biopsy can be recommended. (Source: European Journal of Surgical Oncology)

Solitary Dilated Duct Identified at Mammography: Outcomes Analysis

American Journal of Roentgenology — Thu, 21 Jan 2010 20:14:22 +0100

CONCLUSION. Solitary dilated duct is a rare mammographic finding, this series being the largest reported to date. Although few cases are studied, solitary dilated duct appears to have a greater than 2% likelihood of malignancy, sufficiently high to suggest that a suspicious (BI-RADS 4a) assessment may be appropriate. (Source: American Journal of Roentgenology)

Take Carcinoma Out of DCIS and Ease Off Treatment

Medscape Today Headlines — Thu, 21 Jan 2010 19:25:29 +0100

Medscape Medical News (Source: Medscape Today Headlines)

Ductal carcinoma in situ of breast needs to be stratified further according to risk of progressing

BMJ Online First — Wed, 20 Jan 2010 12:40:31 +0100

(Source: BMJ Online First)

Pre-op Mammogram Reduces The Need For Mastectomy In Women With DCIS

Health News from Medical News Today — Wed, 20 Jan 2010 11:00:00 +0100

Over 60 per cent of women who have a form of breast cancer in the milk ducts (DCIS*) are spared a mastectomy, according to latest research published today in the British Journal of Cancer. Researchers for the Sloane Project** examined how the size of the DCIS - measured by both imaging and pathology - related to the surgeon's decision of whether to conserve or remove the breast. They found that, out of 2,500 women who had DCIS detected by breast screening, around 70 per cent of patients had conservation surgery to remove the disease and save the breast... (Source: Health News from Medical News Today)

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Pre-op Mammogram Reduces The Need For Mastectomy In Women With DCIS

Breast Cancer News From Medical News Today — Wed, 20 Jan 2010 11:00:00 +0100

Over 60 per cent of women who have a form of breast cancer in the milk ducts (DCIS*) are spared a mastectomy, according to latest research published today in the British Journal of Cancer. Researchers for the Sloane Project** examined how the size of the DCIS - measured by both imaging and pathology - related to the surgeon's decision of whether to conserve or remove the breast... (Source: Breast Cancer News From Medical News Today)

Axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for carcinoma of the breast

Cancer — Wed, 20 Jan 2010 00:00:00 +0100

The timing and accuracy of axillary sentinel lymph node biopsy (SLNB) in patients who are receiving neoadjuvant chemotherapy (NACT) for breast cancer are controversial. To examine the accuracy of SLNB after NACT, the authors performed SLNB after chemotherapy on all of patients who received NACT at their institution starting in January 1997.Seventy-nine women who underwent NACT between 1997 and 2008 comprised this study and were divided as follows: 4 women had stage I disease, 60 women had stage II disease, and 15 women had stage III disease, including 10 women who had multicentric disease. Thirty-nine women (49.4%) had clinical evidence of axillary metastasis (N1-N2) at the time of diagnosis. The regimen, the duration of treatment, and the number of cycles of NACT depended on clinical resp...

Socioeconomic disparities in the decline in invasive breast cancer incidence

Breast Cancer Research and Treatment — Tue, 19 Jan 2010 17:45:47 +0100

We examined the decline in breast cancer incidence according to county-level socioeconomic indicators using data from the Surveillance, Epidemiology and End Results (SEER) program. Since socioeconomic status is associated with mammography screening, we also examined the relation between incidence of ductal carcinoma in situ (DCIS; a strong marker of mammography utilization) and the decline in invasive breast cancer. The reduction in invasive breast cancer incidence between 1998–2001 and 2003–2006 in the SEER 9 registries was greatest among women living in counties with higher median household income (−16% change for ≥$85,000 vs. -4% for <$35,000; P trend < 0.01) and a higher percentage of adults aged 25 years or older with a bachelor’s degree (−13% ch...

Researchers tackle ductal carcinoma in situ and its many unanswered questions

ScienceDaily Headlines — Tue, 19 Jan 2010 07:00:00 +0100

In a new paper, researchers review available data on diagnosis and management of ductal carcinoma in situ (DCIS), and offer recommendations for the field. These include identification of better risk stratification methods, consideration of the elimination of the word "carcinoma" from the name, and further investigation into whether imaging technology and guidelines can be modified to focus on high-risk lesions. (Source: ScienceDaily Headlines)

The Use of Oncoplastic Reduction Techniques to Reconstruct Partial Mastectomy Defects in Women with Ductal Carcinoma In Situ

The Breast Journal — Tue, 19 Jan 2010 00:00:00 +0100

This study suggests that although oncoplastic reduction techniques are a reasonable approach for women with DCIS, stricter patient selection and improved confirmation of negative margins will minimize the need for either re-excisions or completion mastectomy and reconstruction. (Source: The Breast Journal)

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Overexpression of the oncogenic signal transducer Gab2 occurs early in breast cancer development

International Journal of Cancer — Tue, 19 Jan 2010 00:00:00 +0100

Gab2, a docking-type signaling protein with demonstrated oncogenic potential, is overexpressed in breast cancer, but its prognostic significance and role in disease evolution remain unclear. Immunohistochemical detection of Gab2 in a large cohort of primary human breast cancers of known outcome revealed that while Gab2 expression was positively correlated with increased tumor grade, it did not correlate with disease recurrence or breast cancer-related death in the total cohort or in patients stratified according to lymph node, estrogen receptor (ER) or HER2 status. Interestingly, analysis of a "progression series" that included premalignant and preinvasive breast lesions as well as samples of metastatic disease revealed that Gab2 expression was significantly enhanced in the earliest lesion...

Predictors of invasion in needle core biopsies of the breast with ductal carcinoma in situ

Modern Pathology AOP — Fri, 15 Jan 2010 00:00:00 +0100

Authors: Edna May L Go, Siu-Ki Chan, Joaquim S L Vong, Philip C W Lui, Anthony W H Chan, Tony K F Ma, Mark A Ang, Bonita K B Law, Puay-Hoon Tan & Gary M Tse (Source: Modern Pathology AOP)

Ductal Carcinoma In Situ And Its Many Unanswered Questions

Health News from Medical News Today — Thu, 14 Jan 2010 13:00:00 +0100

An article and commentary published online January 13 in the Journal of the National Cancer Institute review available data on diagnosis and management of ductal carcinoma in situ (DCIS), and offer recommendations for the field. These include identification of better risk stratification methods, consideration of the elimination of the word "carcinoma" from the name, and further investigation into whether imaging technology and guidelines can be modified to focus on high-risk lesions... (Source: Health News from Medical News Today)

Ductal Carcinoma In Situ And Its Many Unanswered Questions

Cancer / Oncology News From Medical News Today — Thu, 14 Jan 2010 13:00:00 +0100

Researchers tackle ductal carcinoma in situ and its many unanswered questions

EurekAlert! - Cancer — Wed, 13 Jan 2010 05:00:00 +0100

(Journal of the National Cancer Institute) An article and commentary published online Jan. 13 in the Journal of the National Cancer Institute review available data on diagnosis and management of ductal carcinoma in situ (DCIS), and offer recommendations for the field. These include identification of better risk stratification methods, consideration of the elimination of the word "carcinoma" from the name, and further investigation into whether imaging technology and guidelines can be modified to focus on high-risk lesions. (Source: EurekAlert! - Cancer)

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Immunohistochemical analysis of oxidative stress and DNA repair proteins in normal mammary tissue and breast cancer tumors

BMC Cancer — Mon, 11 Jan 2010 00:00:00 +0100

Conclusions: Our studies suggest that oxidative stress and DNA repair proteins not only protect normal cells from the damaging effects of ROS, but may also promote survival of mammary tumor cells. (Source: BMC Cancer)

Impact of AdipoR1 expression on breast cancer development.

Gynecologic Oncology — Mon, 11 Jan 2010 00:00:00 +0100

CONCLUSIONS: The altered expression of AdipoR1 in invasive breast cancer compared to DCIS suggests that the receptor-binding protein adiponectin might exert growth inhibitory effects that are overcome in transformation of preinvasive to invasive breast cancer. PMID: 20071013 [PubMed - as supplied by publisher] (Source: Gynecologic Oncology)

Frequent aberrant DNA methylation of ABCB1, FOXC1, PPP2R2B and PTEN in ductal carcinoma in situ and early invasive breast cancer

Breast Cancer Research — Thu, 07 Jan 2010 00:00:00 +0100

IntroductionDuctal carcinoma in situ (DCIS) is a non-invasive lesion of the breast that is frequently detected by mammography and subsequently removed by surgery. However, it is estimated that about half of the detected lesions would never have progressed into invasive cancer. Identifying DCIS and invasive cancer specific epigenetic lesions and understanding how these epigenetic changes are involved in triggering tumour progression is important for a better understanding of which lesions are "at risk" of becoming invasive. Methods: Quantitative DNA methylation analysis of ABCB1, CDKN2A/p16INK4a, ESR1, FOXC1, GSTP1, IGF2, MGMT, MLH1, PPP2R2B, PTEN and RASSF1A was performed by pyrosequencing in a series of 27 pure DCIS, 28 small invasive ductal carcinomas (IDCs), 34 IDCs with a DCIS componen...

Frequent aberrant DNA methylation of ABCB1, FOXC1, PPP2R2B and PTEN in ductal carcinoma in situ and early invasive breast cancer

Breast Cancer Research — Thu, 07 Jan 2010 00:00:00 +0100

The Ductal Carcinoma In Situ (DCIS) Dilemma

Academic Radiology — Wed, 06 Jan 2010 15:11:38 +0100

Detecting, classifying (grading), treating, and managing ductal carcinoma in situ (DCIS), and other high-risk abnormalities (eg, atypical ductal hyperplasia [ADH]), of the breast remains an ever-evolving, complicated, extremely expensive, and controversial area of interest. (Source: Academic Radiology)

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Ductal Carcinoma In Situ: Should the Name Be Changed?

JNCI — Tue, 05 Jan 2010 21:01:46 +0100

(Source: JNCI)

StatBite: Relative Survival and Incidence Rates: Ductal Carcinoma In Situ

JNCI — Tue, 05 Jan 2010 21:01:46 +0100

(Source: JNCI)

Radiological and pathological size estimations of pure ductal carcinoma in situ of the breast, specimen handling and the influence on the success of breast conservation surgery: a review of 2564 cases from the Sloane Project

British Journal of Cancer AOP — Tue, 05 Jan 2010 00:00:00 +0100

Authors: J Thomas, A Evans, J Macartney, S E Pinder, A Hanby, I Ellis, O Kearins, T Roberts, K Clements, G Lawrence & H Bishop (Source: British Journal of Cancer AOP)

Cooperation of Notch and Ras/MAPK signaling pathways in human breast carcinogenesis

Molecular Cancer — Wed, 23 Dec 2009 00:00:00 +0100

Conclusions: High level expression of Notch receptors and ligands, and its increased activation in several breast cancers and early precursors places Notch signaling as a key player in breast cancer pathogenesis. Its cooperation with the Ras/MAPK pathway in transformation offers combined inhibition of the two pathways as a new modality for breast cancer treatment. (Source: Molecular Cancer)

Gene amplification in ductal carcinoma in situ of the breast

Breast Cancer Research and Treatment — Mon, 21 Dec 2009 23:02:34 +0100

Abstract Multiple different biologically and clinically relevant genes are often amplified in invasive breast cancer, including HER2, ESR1, CCND1, and MYC. So far, little is known about their role in tumor progression. To investigate their significance for tumor invasion, we compared pure ductal carcinoma in situ (DCIS) and DCIS associated with invasive cancer with regard to the amplification of these genes. Fluorescence in situ hybridization (FISH) was performed on a tissue microarray containing samples from 130 pure DCIS and 159 DCIS associated with invasive breast cancer. Of the latter patients, we analyzed the intraductal and invasive components separately. In addition, lymph node metastases of 23 patients with invasive carcinoma were included. Amplification rates of p...

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New Type Of Breast Cancer Stops Women In Their Tracks

Cancercompass News: Breast Cancer — Sat, 19 Dec 2009 00:00:00 +0100

Laufer was diagnosed with a perplexing condition called ductal carcinoma in situ, or DCIS, a growth of malignant cells inside the milk ducts of the breast. Though some doctors describe the condition to patients as a very early breast cancer, others compare it to a precancer. (Source: Cancercompass News: Breast Cancer)

Multimodality Screening of High-Risk Women: A Prospective Cohort Study [Breast Cancer]

Journal of Clinical Oncology — Thu, 17 Dec 2009 23:02:56 +0100

Conclusion The addition of MRI to mammography in the high-risk group has the greatest potential to detect additional mammographically occult cancers. The incremental cancer yield of WBUS and DM is much less. (Source: Journal of Clinical Oncology)

Reproducibility of new classification schemes for the pathology of ductal carcinoma in situ of the breast

Advances in Anatomic Pathology — Tue, 15 Dec 2009 15:00:31 +0100

No abstract available (Source: Advances in Anatomic Pathology)

SABCS: Adjuvant Therapy for DCIS Reduces the Risk of Recurrence (CME/CE)

MedPage Today Hematology/Oncology — Tue, 15 Dec 2009 13:29:59 +0100

SAN ANTONIO (MedPage Today) -- Adjuvant therapy for ductal carcinoma in situ (DCIS) significantly reduced the risk of breast cancer recurrence, but radiotherapy and tamoxifen affected recurrence patterns differently, according to long-term data from a large, randomized clinical trial. (Source: MedPage Today Hematology/Oncology)

Benefits Of Shortened Breast Radiation Course Presented At SABCS

Health News from Medical News Today — Mon, 14 Dec 2009 12:00:00 +0100

New research being presented this week at the 32nd Annual CTRC-AACR San Antonio Breast Cancer Symposium by an investigator at The Cancer Institute of New Jersey (CINJ) highlights the benefit of a shortened radiation course to patients with the most common type of non-invasive breast cancer. Sharad Goyal, MD, instructor of radiation oncology at UMDNJ-Robert Wood Johnson Medical School, is the lead researcher on a poster discussion, which focuses on patients with ductal carcinoma in situ (DCIS), who have had a lumpectomy... (Source: Health News from Medical News Today)

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Ductoscopy in the Evaluation and Management of Nipple Discharge

Annals of Surgical Oncology — Fri, 11 Dec 2009 06:54:33 +0100

Conclusions We believe that, as the technology quickly improves, ductoscopy will become more widely accepted and applied for breast disorders, not only as a diagnostic tool but also as a privileged therapeutic option for certain pathologies. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-009-0820-yAuthors Sedat Kamali, Okmeydani Training and Research Hospital General Surgery Istanbul TurkeyÖmer Bender, Okmeydani Training and Research Hospital General Surgery Istanbul TurkeyMehmet T. Aydin, Okmeydani Training and Research Hospital General Surgery Istanbul TurkeyEnis Yuney, Okmeydani Training and Research Hospital General Surgery Istanbul TurkeyGülçin Kamalı, Okmeydani Training and Research Hospital Pathology Istanbul Turkey Journal Ann...

Flat epithelial atypia is a common subtype of B3 breast lesions and is associated with noninvasive cancer but not with invasive cancer in final excision histology

Human Pathology — Fri, 11 Dec 2009 00:00:00 +0100

Summary: The biological behavior and the optimal management of benign breast lesions with uncertain malignant potential, the so-called B3 lesions, found in breast needle core biopsies is still under debate. We addressed this study to compare histologic findings in B3 needle core biopsies with final excision specimens to determine associated rates of malignancy. Consecutive needle core biopsies were performed in a 3-year period (January 1, 2006-December 31, 2008). Biopsies were image-guided (31 by ultrasound, 85 stereotactic vacuum-assisted, 6 unknown) for evaluation of breast abnormalities. We reviewed 122 needle core biopsies with B3 lesions of 91 symptomatic patients and 31 screen-detected women and compared the B3 histologic subtypes with the final excision histology. A total of 1845 ne...

MRI Contrast-Uptake Kinetics Is Telling in DCIS

OncologySTAT Latest News — Wed, 02 Dec 2009 13:47:54 +0100

CHICAGO (EGMN) - Contrast-uptake kinetics at MRI had a 99% negative predictive value in excluding the presence of invasion in a prospective study of 134 women with ductal carcinoma in situ on core biopsy."MRI... (Source: OncologySTAT Latest News)

Abstract IA-14: Molecular alterations that predict premalignancy in breast cancer

Cancer Research — Wed, 02 Dec 2009 04:15:38 +0100

Approximately 15–30% of women diagnosed with ductal carcinoma in situ (DCIS) develop a subsequent tumor event within 10 years after surgical lumpectomy. To date, little is known about the molecular pathways that confer this differential risk for developing subsequent disease. Since DCIS is non-obligate precursor of invasive carcinoma, the majority of DCIS lesions are not associated with subsequent invasive tumors. Likely, many women diagnosed with DCIS who opt for surgery, with or without adjuvant treatment, are being overtreated. Identification of characteristics of DCIS that predict subsequent tumor development would advance our understanding of breast cancer and allow us to stratify a woman's individual risk for subsequent invasive tumors and avoid over- and undertreatment of wome...

Abstract A42: Small molecule activators of p53 for the treatment of inflammatory breast cancer

Cancer Research — Wed, 02 Dec 2009 04:15:23 +0100

Although rare, inflammatory breast cancer (IBC) is the most aggressive form of breast cancer with a 5 year survival of 40% compared to 85% for ductal carcinoma in situ. The standard therapy for this disease is chemo- and radiation therapy; however there are currently no targeted therapies for IBC. Histopathology data suggests that 40–70% of IBC tumors express wild type p53, while approximately 40% are estrogen receptor positive (ER+). The disease is characterized by early and diffuse intravasation of the breast lymphatic vessels by the tumor cells which form emboli that block the drainage of the ducts leading to swelling of the affected breast and erythema. Efforts to increase survival from this often lethal disease have been hindered by the paucity of model systems for studying the ...

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Addition of pathology and biomarker information significantly improves the performance of the Manchester scoring system for BRCA1 and BRCA2 testing

Journal of Medical Genetics — Tue, 01 Dec 2009 18:04:20 +0100

Discussion: Data from breast pathology allowed adjustment of BRCA1 and combined BRCA1/2 scores alone. There was a lack of pathological homogeneity for BRCA2, therefore specific pathological correlates could not be identified. Upward adjustments in BRCA1 mutation prediction scores were made for grade 3 ductal cancers, oestrogen receptor (ER) and triple-negative tumours. Downward adjustments in the score were made for grade 1 tumours, lobular cancer, ductal carcinoma in situ and ER/HER2 positivity. Application of the updated scoring system led to four and nine more mutations in BRCA1 being identified at the 10% and 20% threshold, respectively. Furthermore, 65 and 58 fewer cases met the 10% and 20% threshold, respectively, for testing. Moreover, the adjusted score significantly improved the t...

Analysis of stromal signatures in the tumor microenvironment of ductal carcinoma in situ

Breast Cancer Research and Treatment — Tue, 01 Dec 2009 08:33:05 +0100

This study is a first characterization of these signatures in DCIS. These signatures have significant clinicopathologic associations and tend to be conserved as the tumor progresses from DCIS to invasive breast cancer. Content Type Journal ArticleCategory Preclinical studyDOI 10.1007/s10549-009-0654-0Authors M. Sharma, Stanford University Hospital Department of Pathology Room L235, 300 Pasteur Drive Stanford CA 94305 USAA. H. Beck, Stanford University Hospital Department of Pathology Room L235, 300 Pasteur Drive Stanford CA 94305 USAJ. A. Webster, Stanford University Hospital Department of Pathology Room L235, 300 Pasteur Drive Stanford CA 94305 USAI. Espinosa, Stanford University Hospital Department of Pathology Room L235, 300 Pasteur Drive Stanford CA 94305 USAK. Montgomery, Stanfo...

Fibroblast Hepatocyte Growth Factor Promotes Invasion of Human Mammary Ductal Carcinoma In situ

Cancer Research — Tue, 01 Dec 2009 05:08:12 +0100

Stromal-derived hepatocyte growth factor (HGF) acting through its specific proto-oncogene receptor c-Met has been suggested to play a paracrine role in the regulation of tumor cell migration and invasion. The transition from preinvasive ductal carcinoma in situ (DCIS) to invasive breast carcinoma is marked by infiltration of stromal fibroblasts and the loss of basement membrane. We hypothesized that HGF produced by the infiltrating fibroblasts may alter proteolytic pathways in DCIS cells, and, to study this hypothesis, established three-dimensional reconstituted basement membrane overlay cocultures with two human DCIS cell lines, MCF10.DCIS and SUM102. Both cell lines formed large dysplastic structures in three-dimensional cultures that resembled DCIS in vivo and occasionally developed inv...

Is excisional biopsy indicated for patients with lobular neoplasia diagnosed on percutaneous core needle biopsy of the breast?

American Journal of Surgery — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: Excisional biopsy for lobular neoplasia did not identify understaged carcinoma or alter the rate of subsequent carcinoma. The subsequent carcinoma risk is diffuse and bilateral; it does not correlate with the site at which lobular neoplasia was diagnosed. (Source: American Journal of Surgery)

Young With DCIS? Recurrence Risk Is Higher

Ob.Gyn. News — Tue, 01 Dec 2009 00:00:00 +0100

Women younger than age 45 years who were treated with lumpectomy and radiation for ductal carcinoma in situ were 68% more likely than were older women to have a local recurrence, a large population-based study found. (Source: Ob.Gyn. News)

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Local excision alone enough for highly selected patients with low/intermediate-grade DCIS

HemOncToday.com — Wed, 25 Nov 2009 10:55:00 +0100

(Source: HemOncToday.com)

Mammographic features of breast cancer: Analysis of 118 cases

The Chinese-German Journal of Clinical Oncology — Tue, 24 Nov 2009 07:05:39 +0100

Conclusion The microcalcifications are the most frequently basal X-ray signs in DCIS. Architecture distortion and focal asymmetric density are special X-ray signs that were easily missed. The abnormal vessels are also important accompaniment signs of breast cancer. The use of coned compression technique is particularly important to improve the radiological diagnosis of breast cancer. Content Type Journal ArticleDOI 10.1007/s10330-009-0155-yAuthors Zhijian Cao, Kunming Women and Children Healthcare Hospital Department of Radiology Kunming 650031 China Journal The Chinese-German Journal of Clinical OncologyOnline ISSN 1613-9089Print ISSN 1610-1979 Journal Volume Volume 8 Journal Issue Volume 8, Number 11 / November, 2009 (Source: The Chinese-German Journa...

Nuclear detection of Y-box protein-1 (YB-1) closely associates with progesterone receptor negativity and is a strong adverse survival factor in human breast cancer

BMC Cancer — Tue, 24 Nov 2009 00:00:00 +0100

Conclusions: Monoclonal YB-1 antibody F-E2G5 should be of great value for prospective studies to validate YB-1 as a novel biomarker suitable to optimize breast cancer treatment. (Source: BMC Cancer)

Clonal Relationship Between Closely Approximated Low-Grade Ductal and Lobular Lesions in the Breast: A Molecular Study of 10 Cases.

American Journal of Clinical Pathology — Mon, 23 Nov 2009 04:50:41 +0100

In this study, we analyzed loss of heterozygosity (LOH) in 10 cases of coexistent ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), and invasive carcinoma. DNA from the separate components of each lesion was subjected to LOH analysis using 13 markers on 7 chromosomes. In 7 cases, the DCIS and LCIS shared loss of a common allele, suggesting a clonal relationship. The invasive component shared loss of the same allele in 5 tumors. This finding indicates that coexistent lobular and ductal carcinomas exhibit shared genetic abnormalities, contradicting the conventional concept that these lesions represent separate, exclusive pathways of breast neoplasia. Instead, these traditionally segregated classes of breast cancer may, in fact, share common precursor lesions. PMID: 19926...

Quantitative Diffusion-Weighted Imaging as an Adjunct to Conventional Breast MRI for Improved Positive Predictive Value

American Journal of Roentgenology — Fri, 20 Nov 2009 19:03:24 +0100

CONCLUSION. DWI shows potential for improving the PPV of breast MRI for lesions of varied types and sizes. However, considerable overlap in ADC of benign and malignant lesions necessitates validation of these findings in larger studies. (Source: American Journal of Roentgenology)

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Short-Term Follow-Up of Palpable Breast Lesions With Benign Imaging Features: Evaluation of 375 Lesions in 320 Women

American Journal of Roentgenology — Fri, 20 Nov 2009 19:03:24 +0100

CONCLUSION. Short-term follow-up is a reasonable alternative to biopsy of palpable breast lesions with benign imaging features, particularly for young women with probable fibroadenoma. (Source: American Journal of Roentgenology)

Columnar cell lesions and pseudoangiomatous hyperplasia like stroma: is there an epithelial-stromal interaction?

International Journal of Clinical and Experimental Pathology — Thu, 19 Nov 2009 10:38:02 +0100

Authors: Recavarren RA, Chivukula M, Carter G, Dabbs DJ The significance of association between cancer and its microenvironment has been increasingly recognized. It has been shown in animal models that interaction between neoplastic epithelial cells and adjacent stroma can modulate tumor behavior. Carcinoma associated stromal cells can transform normal epithelial cells into neoplastic cells. In breast, columnar cell lesions are non-obligate precursors of low grade ductal carcinoma in situ. Columnar cell lesions can be seen intimately associated with PASH-like-stroma, a lesion we termed as CCPLS. Our aim is to investigate epithelial-stromal interactions in CCPLS and compare them to PASH without columnar cell lesions in breast core needle biopsies. Normal terminal duct lobular unit (TDLU...

Clinical Implications of Subcategorizing BI-RADS 4 Breast Lesions associated with Microcalcification: A Radiology–Pathology Correlation Study

The Breast Journal — Thu, 19 Nov 2009 00:00:00 +0100

Abstract: Currently radiologists have the option of subcategorizing BI-RADS 4 breast lesions into 4A (low suspicion for malignancy), 4B (intermediate suspicion of malignancy), and 4C (moderate concern, but not classic for malignancy). To determine the clinical significance of BI-RADS 4 subcategories and the common pathologic changes associated with these mammographic lesions, a retrospective review of 239 consecutive stereotactic-needle core biopsies (SNCB) for microcalcifications was performed. All 239 SNCBs were BI-RADS 4 lesions, and of these, 191 were subcategorized to 4A, 4B or 4C. Ninety-four of 191 (49%) were 4A, 73 (38%) were 4B, and 24 (13%) were 4C. Fibrocystic change was the most common finding (66/239; 28%) followed by ductal carcinoma in situ (DCIS) accounting for 23% of cases...

Magnetic Resonance Imaging Screening of the Contralateral Breast in Women With Newly Diagnosed Breast Cancer: Systematic Review and Meta-Analysis of Incremental Cancer Detection and Impact on Surgical Management [REVIEW ARTICLE]

Journal of Clinical Oncology — Wed, 18 Nov 2009 23:02:37 +0100

Conclusion MRI detects contralateral lesions in a substantial proportion of women, but does not reliably distinguish benign from malignant findings. Relatively high ICDR may be due to selection bias and/or overdetection. Women must be informed of the uncertain benefit and potential harm, including additional investigations and surgery. (Source: Journal of Clinical Oncology)

Declining recurrence among ductal carcinoma in situ patients treated with breast-conserving surgery in the community setting

Breast Cancer Research — Wed, 18 Nov 2009 00:00:00 +0100

Conclusions: The marked increase in the 1990s in the use of adjuvant therapy for DCIS patients treated with BCS in the community setting only partially explains the 50% decline in risk of recurrence risk. Changes in pathology factors have likely also contributed to this decline. (Source: Breast Cancer Research)

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Excision alone inadequate for high grade DCIS

MedWire News - Oncology — Fri, 13 Nov 2009 13:48:26 +0100

Excision alone is inadequate treatment for patients with high-grade ductal carcinoma in situ, but may be suitable for patients with low- or intermediate-grade lesions, US study findings indicate. (Source: MedWire News - Oncology)

Excision alone inadequate for high grade DCIS

MedWire News - Breast Cancer — Fri, 13 Nov 2009 13:48:25 +0100

Can breast MRI computer-aided detection (CAD) improve radiologist accuracy for lesions detected at MRI screening and recommended for biopsy in a high-risk population?

Clinical Radiology — Thu, 12 Nov 2009 15:24:38 +0100

Conclusion: The breast MRI CAD system used could not improve the radiologists' accuracy for distinguishing all malignant from benign lesions, due to the poor sensitivity for DCIS detection. (Source: Clinical Radiology)

Correction: Parathyroid Hormone-Related Protein Protects against Mammary Tumor Emergence and Is Associated with Monocyte Infiltration in Ductal Carcinoma In situ

Cancer Research — Thu, 12 Nov 2009 05:08:18 +0100

(Source: Cancer Research)

A unique proteolytic fragment of alpha1-antitrypsin is elevated in ductal fluid of breast cancer patient

Breast Cancer Research and Treatment — Mon, 09 Nov 2009 18:26:47 +0100

In conclusion, elevated C-41/42 is likely the result of elevated AAT synthesis, and the activity of specific MMPs present within the tumor. As other C-terminal fragments of AAT are reported to function as tumor-derived suppressors to the host immune-system, elevated C-41/42 may also be predictive of a poor outcome. Content Type Journal ArticleCategory Preclinical studyDOI 10.1007/s10549-009-0625-5Authors Junma Zhou, Johns Hopkins Medical Institutions Department of Pathology Baltimore MD 21287 USABruce Trock, Johns Hopkins Medical Institutions Department of Urology Baltimore MD 21287 USATheodore N. Tsangaris, Johns Hopkins Medical Institutions Department of Surgery Baltimore MD 21287 USANeil B. Friedman, Hoffberger Breast Center at Mercy Hospital Baltimore MD 21202 USADeanna Shapiro,...

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Breast Cancer Deception Month: Hiding the Truth beneath a Sea of Pink, Part V

NaturalNews.com — Sun, 08 Nov 2009 07:00:00 +0100

(NaturalNews) As we near the end of Breast Cancer Awareness Month, once again our country has been awash from shore to shore in a sea of pink - from pink ribbons and donation boxes to pink products, charity promotions, celebrities by the score and even pink cleats on NFL players. Tragically, most people are unaware of the dark history of Breast Cancer Awareness Month (BCAM) and of the players past and present who have misused it to direct people and funds away from finding a true cure, while covering up their own roles in causing and profiting from cancer.In this installment of the series, we will examine the dangers of over-screening for cancer and the lack of progress in breast cancer prevention and cures.The Dangers of Over-Screening for CancerA new analysis published this month in the ...

Clinical Dilemma of Ductal Carcinoma in Situ [EDITORIALS]

Journal of Clinical Oncology — Fri, 06 Nov 2009 23:02:18 +0100

(Source: Journal of Clinical Oncology)

Local Excision Alone Without Irradiation for Ductal Carcinoma In Situ of the Breast: A Trial of the Eastern Cooperative Oncology Group [Breast Cancer]

Journal of Clinical Oncology — Fri, 06 Nov 2009 23:02:18 +0100

Conclusion Rigorously evaluated and selected patients with low- to intermediate-grade DCIS with margins 3 mm or wider had an acceptably low rate of ipsilateral breast events at 5 years after excision without irradiation. Patients with high-grade lesions had a much higher rate, suggesting that excision alone is inadequate treatment. Further follow-up is necessary to document long-term results. (Source: Journal of Clinical Oncology)

Analysis of the expression of hyaluronan in intraductal and invasive carcinomas of the breast

Journal of Cancer Research and Clinical Oncology — Fri, 06 Nov 2009 18:57:53 +0100

Conclusions Our study indicates a proportionally higher area of hyaluronan expression in DCIS with a microinvasive component than in pure DCIS, suggesting a key role of this glycosaminoglycan in the early invasive phase of breast carcinomas. Thus, hyaluronan could play an important function in determining the migratory phenotype of cancer cells. Larger size tumors appear to demonstrate an intricate balance between hyaluronan synthesis and degradation, thus conditioning intratumoral heterogeneity in the hyaluronan metabolism. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00432-009-0713-2Authors Maria Daniela Corte, Hospital de Jove Unidad de Investigación Gijón SpainLuis Ovidio González, Hospital de Jove Unidad de Investigación Gijón SpainSara ...

Ductal Carcinoma In Situ — A Highly Treatable Breast Cancer

Mayo Clinic Health Information — Thu, 05 Nov 2009 16:53:03 +0100

Doctors and their patients with a specific type of breast cancer called ductal carcinoma in situ (DCIS) are successfully employing treatments to beat the disease, with 10-year survival rates approaching nearly 100 percent. (Source: Mayo Clinic Health Information)

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Risk of carcinoma after subsequent excision of benign papilloma initially diagnosed with an ultrasound (US)-guided 14-gauge core needle biopsy: a prospective observational study

European Radiology — Wed, 04 Nov 2009 19:50:14 +0100

Conclusion Surgical excision should be considered for benign intraductal papillomas above 1.5 cm in size. Content Type Journal ArticleCategory BreastDOI 10.1007/s00330-009-1649-2Authors Jung Min Chang, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center Department of Radiology and Clinical Research Institute Chongno-gu Seoul Republic of KoreaWoo Kyung Moon, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center Department of Radiology and Clinical Research Institute Chongno-gu Seoul Republic of KoreaNariya Cho, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Res...

In Atypical Ductal Hyperplasia, Absence of Cytokeratin 5 Expression Is Ominous

Medscape Internal Medicine Headlines — Tue, 03 Nov 2009 15:09:59 +0100

Cytokeratin 5 (CK5) expression in breast tissue indicates ductal carcinoma in situ, even if the patient presents with atypical ductal hyperplasia; the presence of CK5 is a good prognosticator. Medscape Medical News (Source: Medscape Internal Medicine Headlines)

Ductal carcinoma in situ: X-ray fluorescence microscopy and dynamic contrast-enhanced MR imaging reveals gadolinium uptake within neoplastic mammary ducts in a murine model.

Radiology — Sun, 01 Nov 2009 00:00:00 +0100

CONCLUSION: These results provide insight into the physiologic basis of contrast enhancement of DCIS lesions on DCE MR images: Gadolinium penetrates and collects inside neoplastic ducts. PMID: 19864527 [PubMed - in process] (Source: Radiology)

DCIS More Likely to Recur in Younger Women

Internal Medicine News — Sun, 01 Nov 2009 00:00:00 +0100

Women younger than age 45 years who were treated with lumpectomy and radiation for ductal carcinoma in situ were 68% more likely to have a local recurrence than were older women, a large population-based study found. (Source: Internal Medicine News)

Apocrine ductal carcinoma in situ involving a sclerosing lesion with adenosis: report of a case.

Archives of Pathology and Laboratory Medicine — Sun, 01 Nov 2009 00:00:00 +0100

Authors: Visscher DW Apocrine metaplasia is a ubiquitous component of the mammary fibrocystic change spectrum. Although mostly associated with cysts, apocrine metaplasia can also present as a proliferative lesion, rarely with cytologic atypism. Apocrine atypia is characterized by 3-fold nuclear enlargement, multiple nucleoli, and hyperchromatism and generally arises in florid adenosis or radial sclerosing lesions. Dramatic apocrine atypia may be very difficult to distinguish from apocrine ductal carcinoma in situ. The latter is distinguished from apocrine atypia by greater extent of the lesion (>0.4 cm) and the presence of greater nuclear pleomorphism with nuclear membrane irregularity. The clinical significance of apocrine atypia is poorly understood and reflects the lack of publis...

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Clinical implications for nestin protein expression in breast cancer

Cancer Science — Sat, 31 Oct 2009 00:00:00 +0100

We examined mastectomy specimens from 150 breast cancers and matching, adjacent non-cancerous tissues using immunohistochemistry and western blotting. Overall, triple-negative breast cancers [ndash] that is, breast cancers that do not express estrogen receptors (ER), progesterone receptors (PR), or human epidermal growth factor receptor 2 (HER2/neu) [ndash] had higher expression rates for nestin than the other breast cancers (57.14%vs 9.30%; P < 0.001). In triple-negative breast cancers, significantly increased nestin expression rates were observed in patients with lymph node metastasis compared with those without node metastasis (25.00%vs 76.92%; P = 0.032). A similar phenomenon was observed for invasive ductal carcinomas compared with ductal carcinoma in situ (16.67%vs 73.33%; P = 0.046)...

Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition

Breast Cancer Research and Treatment — Thu, 29 Oct 2009 19:51:16 +0100

Abstract In order to assess the characteristics of malignant breast lesions those were not detected during screening by MR imaging. In the Dutch MRI screening study (MRISC), a non-randomized prospective multicenter study, women with high familial risk or a genetic predisposition for breast cancer were screened once a year by mammography and MRI and every 6 months with a clinical breast examination (CBE). The false-negative MR examinations were subject of this study and were retrospectively reviewed by two experienced radiologists. From November 1999 until March 2006, 2,157 women were eligible for study analyses. Ninety-seven malignant breast tumors were detected, including 19 DCIS (20%). In 22 patients with a malignant lesion, the MRI was assessed as BI-RADS 1 or 2. O...

Study Finds Benefits With Full-Field Digital Mammography

Modern Medicine — Thu, 29 Oct 2009 00:00:00 +0100

Full-field digital mammography, along with computer-aided diagnosis, may provide improved detection of microcalcifications and ductal carcinoma in situ, according to research published in the November issue of Radiology. (Source: Modern Medicine)

Why Do Purely Intraductal Cancers Enhance on Breast MR Images? [Science to Practice]

Radiology — Wed, 28 Oct 2009 16:04:57 +0100

On the basis of the results of the animal study performed by Jansen et al and clinical observations, there is compelling evidence to suggest that the imaging phenotype of a ductal carcinoma in situ (DCIS) lesion (its detectability at mammography and MR imaging, specifically the presence or absence of calcifications on mammograms and the presence or absence of calcifications and the degree of their enhancement on MR images) conveys important biologic information that will be useful when guiding DCIS treatment. (Source: Radiology)

Breast Cancer Screening Results 5 Years after Introduction of Digital Mammography in a Population-based Screening Program [Breast Imaging]

Radiology — Wed, 28 Oct 2009 16:04:57 +0100

Results indicate that with full-field digital mammography (FFDM) using computer-aided diagnosis (CAD) and double reading, the detection is as good as that with screen-film mammography, and detection of clustered microcalcifications and ductal carcinoma in situ is improved with FFDM using CAD. (Source: Radiology)

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Ductal Carcinoma in Situ: X-ray Fluorescence Microscopy and Dynamic Contrast-enhanced MR Imaging Reveals Gadolinium Uptake within Neoplastic Mammary Ducts in a Murine Model [Experimental Studies]

Radiology — Wed, 28 Oct 2009 16:04:57 +0100

We used a transgenic mouse model of breast cancer to investigate contrast enhancement of ductal carcinoma in situ (DCIS) on clinical dynamic contrast material–enhanced (DCE) MR images of the breast, and we have shown via two independent routes—DCE MR imaging and x-ray fluorescence microscopy—that after injection of gadodiamide, there is gadolinium uptake inside ducts distended with murine DCIS. (Source: Radiology)

For DCIS, Outcomes With Excision Alone Acceptable at 5 Years

Medscape Today Headlines — Tue, 27 Oct 2009 22:08:05 +0100

A new study begs the question of whether or not local surgery alone is acceptable as a treatment option for women with ductal carcinoma in situ (DCIS). Medscape Medical News (Source: Medscape Today Headlines)

Women's HealthSource Highlights Ductal Carcinoma In Situ

Cancercompass News: Breast Cancer — Tue, 27 Oct 2009 00:00:00 +0100

Serum protein signature may improve detection of ductal carcinoma in situ of the breast

Oncogene — Mon, 26 Oct 2009 00:00:00 +0100

Authors: J Solassol, P Rouanet, P J Lamy, C Allal, G Favre, T Maudelonde & A Mangé (Source: Oncogene)

Should pathologists send all or only selected slides for patient-requested interlaboratory second opinion?

American Journal of Clinical Pathology — Sat, 24 Oct 2009 14:00:27 +0100

Authors: Renshaw MA, Renshaw AA, Gould EW For interlaboratory second opinions requested by patients or clinicians, whether all or selected slides should be sent is unknown. We compared the disagreement rate for requested second opinions for 4 years of sending selected slides with the rate for 1 year of sending all slides. Disagreements were identified in 81 (13.6%) of 596 cases (468 selected slides, 128 all slides). The disagreement rate was less when sending selected slides (n = 58 [12%]) vs all slides (n = 23 [18%]; P = .03). Only 5 cases were identified with disagreement related to whether all or selected slides were sent (selected slides, 1 case [slide of interest inadvertently not chosen]; all slides, 4 cases; P = .03). When all slides were sent (disagreement in number of positive...

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Local Excision Alone Without Irradiation for Ductal Carcinoma in Situ of the Breast: A Trial of the Eastern Cooperative Oncology Group

OncologySTAT Journal Scans — Sat, 24 Oct 2009 12:47:17 +0100

In this prospective analysis, women with low- and intermediate-grade ductal carcinoma in situ of the breast (n = 565) were at low risk (6%) for recurrence at 5 years after excision without radiation therapy.... Access... (Source: OncologySTAT Journal Scans)

Predictive factors for breast cancer in patients diagnosed atypical ductal hyperplasia at core needle biopsy

World Journal of Surgical Oncology — Thu, 22 Oct 2009 23:00:00 +0100

Conclusions: Age (over 50-years) at the time of biopsy is an independent predictive factor for breast cancer at surgical excision in patients with diagnosed ADH at CNB. For patients diagnosed with ADH at CNB, only complete surgical excision is the suitable treatment option, because we could not find any combination of factors that can safely predict the absence of DCIS or invasive cancer in a case of ADH. (Source: World Journal of Surgical Oncology)

The association of metabolic syndrome with triple-negative breast cancer

Breast Cancer Research and Treatment — Thu, 22 Oct 2009 19:04:31 +0100

Abstract Metabolic syndrome, a conglomerate of obesity, insulin resistance, dyslipidemia, and hypertension has been linked with an increased risk of breast cancer. We investigated the possible association of highly aggressive triple-negative breast cancer and the metabolic syndrome. Information on metabolic syndrome components and tumor characteristics were reviewed in a cohort of 176 patients (including 86 triple-negatives). Retrospective comparison was performed using Pearson Chi-square test or Student’s t test for data analysis. A statistically significant association of triple-negative breast cancer with the metabolic syndrome was observed. In accordance with the NCEP (National Cholesterol Education Program) definition, 58.1% of triple-negative patients had metabolic...

The Confusion Over DCIS: What to Do About 'Stage Zero' Breast Cancer?

U.S. News - Health — Thu, 22 Oct 2009 18:30:00 +0100

Abnormal cells proliferating in a breast duct means surgery (at least). Will it always be that way? (Source: U.S. News - Health)

What is an Adequate Margin for Breast-Conserving Surgery? Surgeon Attitudes and Correlates

Annals of Surgical Oncology — Thu, 22 Oct 2009 05:59:42 +0100

Conclusions Wide variation in BCS margin definition exists. Variation is similar for invasive cancer and DCIS with RT, with more specialized surgeons choosing smaller margins. In DCIS without RT, more specialized surgeons favored larger margins. A standardized margin definition may significantly affect re-excision rates. Content Type Journal ArticleCategory Breast OncologyDOI 10.1245/s10434-009-0765-1Authors Michelle Azu, Memorial Sloan-Kettering Cancer Center Breast Service, Department of Surgery New York USAPaul Abrahamse, University of Michigan Department of Internal Medicine Ann Arbor MI USASteven J. Katz, University of Michigan Department of Internal Medicine Ann Arbor MI USAReshma Jagsi, University of Michigan Department of Radiation Oncology Ann Arbor MI USAMon...

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Utility of an upright-type 11-gauge stereotactic vacuum-assisted biopsy device (Mammotome®) for the diagnosis of breast microcalcifications

The Chinese-German Journal of Clinical Oncology — Wed, 21 Oct 2009 19:13:47 +0100

Conclusion The upright stereotactic 11-gauge Mammotome procedure is an effective and reliable method for the diagnosis of breast microcalcifications. It has minimal side effects. For lesions diagnosed as ADH or DCIS with the 11-gauge Mammotome, subsequent surgical excision should be performed. Content Type Journal ArticleDOI 10.1007/s10330-009-0100-0Authors Ming Yang, the First Hospital of Jilin University Department of Breast Surgery Changchun 130021 ChinaTakanori Ishida, Tohoku University School of Medicine Department of Surgical Oncology Sendai JapanMotohiro Takeda, Tohoku University School of Medicine Department of Surgical Oncology Sendai JapanNoriaki Ohuchi, Tohoku University School of Medicine Department of Surgical Oncology Sendai Japan Journal The Chin...

Impact of Pathological Characteristics on Local Relapse After Breast-Conserving Therapy: A Subgroup Analysis of the EORTC Boost Versus No Boost Trial [Breast Cancer]

Journal of Clinical Oncology — Fri, 16 Oct 2009 22:02:50 +0100

Conclusion Young age and high-grade invasive ductal cancer were the most important risk factors for local relapse, while margin status had no significant influence. A boost dose of 16 Gy significantly reduced the negative effects of both young age and high-grade invasive cancer. (Source: Journal of Clinical Oncology)

Occult Nipple Involvement in Breast Cancer: Clinicopathologic Findings in 316 Consecutive Mastectomy Specimens [Breast Cancer]

Journal of Clinical Oncology — Fri, 16 Oct 2009 22:02:50 +0100

Conclusion Nipple-sparing mastectomy may be suitable for selected cases of breast carcinoma with low probability of nipple involvement by carcinoma and prophylactic procedures. A retroareolar en-face margin may be used to test for occult involvement in patients undergoing nipple-sparing mastectomy. (Source: Journal of Clinical Oncology)

Significance of nipple enhancement of Paget’s disease in contrast enhanced breast MRI

Archives of Gynecology and Obstetrics — Fri, 16 Oct 2009 18:01:33 +0100

Conclusion CE breast MRI allows for the correct detection of nipple involvement of Paget’s disease even when clinical information or mammographic/US findings are not provided. Content Type Journal ArticleCategory General GynecologyDOI 10.1007/s00404-009-1244-4Authors Hyeon Sook Kim, The Catholic University of Korea Department of Radiology, St. Paul’s Hospital, College of Medicine Seoul KoreaJee Hyun Seok, The Catholic University of Korea Department of Radiology, St. Mary’s Hospital, College of Medicine Seoul KoreaEun Suk Cha, The Catholic University of Korea Department of Radiology, St. Vincent’s Hospital, College of Medicine 93-6 Ji-dong Paldal-gu Suwon Gyeonggi-do KoreaBong Joo Kang, The Catholic University of Korea Department of Radiology, Seoul St. Mary’s...

Validation of Van Nuys classification in 183 patients with screen detected DCIS, a retrospective analysis

European Journal of Surgical Oncology — Fri, 16 Oct 2009 12:47:10 +0100

Introduction: The Van Nuys Prognostic Index (VNPI) is a numerical index designed to guide treatment following Breast Conserving Surgery for DCIS. It combines size, margin and grade and separates patients into low risk group suitable for treatment with excision only, moderate risk group suitable for excision with radiotherapy and high-risk group where mastectomy is recommended. The authors tested the validity of VNPI and the proposed benefit of adjuvant radiotherapy. (Source: European Journal of Surgical Oncology)

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Can clinical and radiological features predict the need for Sentinel Lymph Node Biopsy in patients with a pre-operative diagnosis of Ductal Carcinoma in Situ, who are eligible for breast conservation surgery?

European Journal of Surgical Oncology — Fri, 16 Oct 2009 12:47:03 +0100

Background: The role for Sentinel Lymph Node Biopsy (SLNB) in patients eligible for breast conservation surgery (BCS) remains controversial. 10-30% of patients with pre-operative diagnosis of DCIS will have an invasive component subsequently detected in the resected specimen. These patients will require a second operation for axillary staging. We sought to identify the characteristics of patients with a pre-operative diagnosis of DCIS eligible for BCS who are most likely to harbour an invasive component, with the aim of identifying those who might benefit from SLNB. (Source: European Journal of Surgical Oncology)

The importance of intraoperative radiography in the surgical management of Ductal Carcinoma in Situ

European Journal of Surgical Oncology — Fri, 16 Oct 2009 12:47:01 +0100

Introduction: Ductal Carcinoma in situ (DCIS) is a non invasive carcinoma. It is a malignant precursor of invasive breast cancer. DCIS is usually not detected as a palpable lesion. It is increasingly identified in mammographic screening. The aim of surgery is to achieve complete excision of the in-situ tumour and to minimise local recurrence. National and regional guidelines emphasise the importance of clear resection margins. They also state that intraoperative specimen radiography should be carried out for all cases of DCIS treated by breast conservation surgery. (Source: European Journal of Surgical Oncology)

Sentinel node biopsy (SNB) in patients with a pre-operative diagnosis of ductal carcinoma in situ (DCIS) but high risk of missed invasive disease

European Journal of Surgical Oncology — Fri, 16 Oct 2009 12:46:55 +0100

Introduction: The routine use of SNB in women with a pre-operative diagnosis of DCIS is controversial. Guidelines suggest it should be performed in women who are at a high risk of occult invasive carcinoma, but criteria for patients not having mastectomy are poorly defined. The aim of this study was to determine if such criteria could be identified retrospectively and then applied prospectively to select patients for SNB. (Source: European Journal of Surgical Oncology)

Androgen receptor coactivator p44/Mep50 in breast cancer growth and invasion.

J Cell Mol Med — Thu, 15 Oct 2009 23:00:00 +0100

In this report, we examined the expression and function of p44 in breast cancer. In addition to being an AR coactivator, p44 also functions as an ER coactivator. In contrast to findings in prostate cancer, the expression of p44 shows strong cytoplasmic expression in morphologically normal terminal ductal lobular units, while nuclear p44 is observed in both ductal carcinoma in situ (DCIS) and invasive carcinoma. Further, overexpression of nuclear-localized p44 stimulates proliferation and invasion in MCF7 breast cancer cells in the presence of estrogen and is ERalpha-dependent. These findings strongly suggest that p44 plays a role in mediating the effects of hormones during tumorigenesis in breast. PMID: 19840198 [PubMed - as supplied by publisher] (Source: J Cell Mol Med)

Comparison of molecular markers expression in vacuum-assisted biopsies and surgical specimens of human breast carcinomas.

Pathology, Research and Practice — Tue, 13 Oct 2009 23:00:00 +0100

In this study, we examined whether vacuum-assisted breast biopsy (VABB) specimens provide an accurate immunohistochemical assessment of estrogen receptors (ER), progesterone receptors (PR), c-erbB-2, and p53 proteins. Thirty-seven consecutive cases with a VABB diagnosis of ductal carcinoma in situ (DCIS) were included. The immunohistochemical expression of ER and PR, c-erbB-2, and p-53 was assessed in VABB and in surgical specimens with pathological concordance. The "clinically relevant concordance rate" (CRCR) was calculated. The CRCRs were 77.8%, 77.8%, and 89% for ER, PR, and c-erbB-2, respectively. Concerning both ER and PR, the clinically relevant expression was higher in VABB specimens. A difference in borderline significance arose concerning c-erbB-2 expression, pointing to more int...

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New Type Of Breast Cancer Stops Women In Their Tracks

Cancercompass News: Breast Cancer — Tue, 13 Oct 2009 00:00:00 +0100

When a mammogram detected a lump in Barbara Laufer's breast, the fear was paralyzing. You think you're going to die, says Laufer, 40, of Burbank, Calif. Laufer was diagnosed with a perplexing condition called ductal carcinoma in situ, or DCIS, a growth of malignant cells inside the milk ducts of the breast. Though some doctors describe the condition to patients as a very early breast cancer, others compare it to a precancer. (Source: Cancercompass News: Breast Cancer)

Flat Epithelial Atypia and Atypical Ductal Hyperplasia: Carcinoma Underestimation Rate

The Breast Journal — Mon, 12 Oct 2009 23:00:00 +0100

This study was carried out to determine the underestimation rate of carcinoma upon surgical biopsy after a diagnosis of flat epithelial atypia and atypical ductal hyperplasia and 11-gauge vacuum-assisted breast biopsy. A retrospective review was conducted of 476 vacuum-assisted breast biopsy performed from May 2005 to January 2007 and a total of 70 cases of atypia were identified. Fifty cases (71%) were categorized as pure atypical ductal hyperplasia, 18 (26%) as pure flat epithelial atypia and two (3%) as concomitant flat epithelial atypia and atypical ductal hyperplasia. Each group were compared with the subsequent open surgical specimens. Surgical biopsy was performed in 44 patients with atypical ductal hyperplasia, 15 patients with flat epithelial atypia, and two patients with flat epi...

ASCO Breast: DCIS Recurs More Often in Younger Women

MedPage Today Hematology/Oncology — Mon, 12 Oct 2009 16:00:59 +0100

SAN FRANCISCO (MedPage Today) -- Young women with ductal carcinoma in situ (DCIS) may get poorer outcomes with breast conserving surgery than older patients do, although survival is unaffected, researchers found. (Source: MedPage Today Hematology/Oncology)

'New' type of breast cancer, DCIS, can put life on hold

USATODAY.com Health — Sun, 11 Oct 2009 23:45:03 +0100

The perplexing condition is rarely life-threatening, but a diagnosis cause result in difficult and painful treatment decisions. (Source: USATODAY.com Health)

Increased Recurrence Risk Seen in Younger Women with DCIS

OncologySTAT Latest News — Fri, 09 Oct 2009 09:04:02 +0100

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Annual Evidence Update on breast cancer: 12-16 October 2009

NeLM - Oncology — Thu, 08 Oct 2009 23:00:00 +0100

Source: NLH Area: News The fifth Annual Evidence Update on breast cancer presents the results of a search for new guidance and systematic reviews since October 2008. This update also provides commentaries from the Breast Cancer Advisory Panel. Topic areas covered include: . Sentinel node identification and classification after neoadjuvant chemotherapy . Clinical application of MRI of ductal carcinoma in situ . Breast cancer presentation and survival in relation to ethnicity and social deprivation . Fertility related concerns of women with breast cancer . Management of hot flushes for women with treatment-induced menopause (Source: NeLM - Oncology)

DCIS Recurrence Rates Higher in Younger Women

Medscape Medical News Headlines — Wed, 07 Oct 2009 15:56:58 +0100

Younger women who undergo breast-conserving surgery and radiotherapy for ductal carcinoma in situ (DCIS) are more likely to experience recurrence than are older women, according to the results of a large population-based study. Reuters Health Information (Source: Medscape Medical News Headlines)

PIK3CA Mutations mostly Begin to Develop in Ductal Carcinoma of the Breast.

Experimental and Molecular Pathology — Tue, 06 Oct 2009 23:00:00 +0100

Authors: Li H, Zhu R, Wang L, Zhu T, Li Q, Chen Q, Wang H, Zhu H Somatic mutations of PIK3CA are found in 20% to 40% of invasive breast cancers. To investigate the frequency of PIK3CA mutations in the intraductal proliferative lesions of the breast, which are precursor lesions for invasive carcinoma, we analyzed 125 intraductal proliferative lesions and 108 invasive breast cancer tissues for PIK3CA mutations in this study. Target cells were precisely isolated using a laser capture microdissection (LCM) system. Genomic DNA was extracted with QIAmp DNA Micro Kit. PCR amplification was done for exons 9 and 20 of PIK3CA, where 90% of mutations clustered, and the products were directly sequenced. Forty-six missense mutations were identified in total, of which, 14 and 32 mutations clustered ...

Comparing interval breast cancer rates in Norway and North Carolina: results and challenges

Journal of Medical Screening — Mon, 05 Oct 2009 20:53:38 +0100

Conclusion Even when applying a common set of definitions of interval cancer, the ICR was lower in Norway than in NC. Different definitions of interval cancer did not influence the ICR within Norway or NC. Organization of screening and screening performance might be major contributors to the differences in ICR between Norway and NC. (Source: Journal of Medical Screening)

MRI versus ultrasonography and mammography for preoperative assessment of breast cancer.

The American Surgeon — Thu, 01 Oct 2009 00:00:00 +0100

Authors: Wasif N, Garreau J, Terando A, Kirsch D, Mund DF, Giuliano AE Mammography and ultrasonography are traditional for preoperative estimation of breast cancer size; magnetic resonance imaging (MRI) is more recent but not as well studied. We compared ultrasonography, mammography, and MRI for preoperative imaging of primary breast cancer presenting as a mass in patients treated at our center over a 2-year period. Of the 61 breast cancers with all three imaging modalities performed, 52 were infiltrating ductal cancer, 5 were infiltrating lobular cancer, 2 were ductal carcinoma in situ, and 2 were other histologic types. When pathologic size was used to determine the accuracy of imaging assessments, the Pearson correlation coefficient was better for MRI (r = 0.80) than ultrasonography...

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George Peters Award: How does breast-specific gamma imaging affect the management of patients with newly diagnosed breast cancer?

American Journal of Surgery — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: In our study group, 22% of patients had a surgical change in management based on BSGI findings. BSGI detected additional carcinoma in 9%. BSGI plays an important role in the clinical management of patients with known breast cancer. (Source: American Journal of Surgery)

Asymptomatic changes in cardiac function can occur in ductal carcinoma-in-situ patients following treatment with HER-2/neu–pulsed dendritic cell vaccines

American Journal of Surgery — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: This is the first description of HER-2/neu targeted vaccination associated with an incidence of cardiac changes, and the induction of cellular immune responses combined with antibody may contribute to changes in cardiac function. (Source: American Journal of Surgery)

Is there concordance of invasive breast cancer pathologic tumor size with magnetic resonance imaging?

American Journal of Surgery — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: Breast MRI is concordant with pathologic tumor size within .5 cm among 53% of patients. Most patients with tumors overestimated by MRI have significant findings in the surrounding breast tissue, the excision of which would be expected to benefit the patient. (Source: American Journal of Surgery)

American Society of Breast Surgeons MammoSite Radiation Therapy System Registry Trial: ductal carcinoma-in-situ subset analysis—4-year data in 194 treated lesions

American Journal of Surgery — Wed, 30 Sep 2009 23:00:00 +0100

Conclusions: The ASBS Registry Trial includes the largest published collection of DCIS treated with APBI. Four-year follow-up shows result similar to those with invasive cancer treated with APBI, as well as DCIS treated with whole breast irradiation. (Source: American Journal of Surgery)