MedWorm: DCIS (Ductal Carcinoma in Situ)

Silencing of tumor suppressor genes RASSF1A, SLIT2, and WIF1 by promoter hypermethylation in hereditary breast cancer

Molecular Carcinogenesis — Thu, 09 Feb 2012 21:17:58 +0100

AbstractPromoter hypermethylation is gaining strength as one of the main mechanisms through which tumor suppressor genes are silenced during tumor progression. Three tumor suppressor genes are frequently found methylated in their promoter, in concordance with absence of expression, RASSF1A, SLIT2, and WIF1. In addition, a previous array‐CGH analysis from our group showed that these genes are found in deleted genomic regions observed in hereditary breast cancer tumors. In the present work we analyzed the methylation status of these three tumor suppressor gene promoters in 47 hereditary breast cancer tumors. Promoter methylation status analysis of hereditary breast tumors revealed high methylation frequencies for the three genes (67% RASSF1A, 80% SLIT2, and 72% WIF1). Additionally, the pre...

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How early breast tumors become deadly: A small group of molecules might hold the answer

EurekAlert! - Medicine and Health — Tue, 07 Feb 2012 05:00:00 +0100

(Ohio State University Medical Center) Researchers have discovered a pattern of molecules that differentiate early-stage breast tumors from invasive, life-threatening cancer. They also found a similar molecular signature that correlated with the aggressiveness of invasive tumors, and with the time to metastasis and overall survival. The findings could offer new strategies for treating breast cancer by blocking progression of early-stage breast cancer called ductal carcinoma in situ to life-threatening invasive cancer. (Source: EurekAlert! - Medicine and Health)

Accelerated Partial Breast Irradiation Using Once-Daily Fractionation: Analysis of 312 Cases with Four Years Median Follow-Up

Radiation Oncology — Mon, 06 Feb 2012 05:00:00 +0100

Conclusions: External beam APBI with once daily fractionation has a low rate of IBF consistent with other published APBI studies. The ASTRO risk stratification did not differentiate a subset of patients with a higher rate of IBF. APBI may be an appropriate treatment for women with DCIS and ILC. (Source: Radiation Oncology)

Proteins and carbohydrates in nipple aspirate fluid predict the presence of atypia and cancer in women requiring diagnostic breast biopsy

BMC Cancer — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: uPA and PAI-1 concentrations in ND were higher in women with atypia and cancer compared to women with benign disease. Combining uPA, PAI-1 and TF in the assessment of women requiring diagnostic breast surgery maximized disease prediction. The assessment of these markers may prove useful in early breast cancer detection. (Source: BMC Cancer)

The incremental value of magnetic resonance imaging for breast surgery planning

Surgery Today — Tue, 31 Jan 2012 16:46:47 +0100

Conclusions Assessment of the tumor size, multifocality, multicentricity, and presence of ductal carcinoma in situ by MRI may lead to misinterpretations in the majority of patients. The surgical approach should not be changed based solely on MRI findings. An accurately interpreted MMG combined with USG may be sufficient in most cases. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00595-012-0137-5Authors Sibel Ozkan Gurdal, Department of Surgery, School of Medicine, Namık Kemal University, 100. yıl mahallesi, Tunca caddesi, No: 32, Tekirdağ, Istanbul, TurkeyBeyza Ozcinar, Departments of Surgery, Istanbul University, Istanbul, TurkeyMunire Kayahan, Departments of Surgery, Bezmialem Vakif University Medical Faculty, Istanbul, TurkeyAbdul...

4-week vaccination regimen knocks out early breast cancer tumors, Penn researchers report

EurekAlert! - Medicine and Health — Mon, 30 Jan 2012 05:00:00 +0100

(University of Pennsylvania School of Medicine) Researchers at the Perelman School of Medicine at the University of Pennsylvania report that a short course of vaccination with an anti-HER2 dendritic cell vaccine made partly from the patient's own cells triggers a complete tumor eradication in nearly 20 percent of women with ductal carcinoma in situ, an early breast cancer. (Source: EurekAlert! - Medicine and Health)

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Factors Noted to Affect Breast Cancer Treatment Decisions of Women Aged 80 and Older

Journal of the American Geriatrics Society — Fri, 27 Jan 2012 05:00:00 +0100

ConclusionThe quality of physician documentation about decision‐making in these women was high. A great amount of thoughtful and complex decision‐making involving patients, family, and physicians occurs after a woman aged 80 and older is diagnosed with breast cancer. (Source: Journal of the American Geriatrics Society)

Overexpression of a novel cell cycle regulator ecdysoneless in breast cancer: a marker of poor prognosis in HER2/neu-overexpressing breast cancer patients

Breast Cancer Research and Treatment — Tue, 24 Jan 2012 07:35:08 +0100

Abstract Uncontrolled proliferation is one of the hallmarks of breast cancer. We have previously identified the human Ecd protein (human ortholog of Drosophila Ecdysoneless, hereafter called Ecd) as a novel promoter of mammalian cell cycle progression, a function related to its ability to remove the repressive effects of Rb-family tumor suppressors on E2F transcription factors. Given the frequent dysregulation of cell cycle regulatory components in human cancer, we used immunohistochemistry of paraffin-embedded tissues to examine Ecd expression in normal breast tissue versus tissues representing increasing breast cancer progression. Initial studies of a smaller cohort without outcomes information showed that Ecd expression was barely detectable in normal breast tissue and i...

Pathologic Complete Response of HER-2 Neu-Positive Invasive Ductal Carcinoma and Ductal Carcinoma In Situ following Neoadjuvant Chemotherapy plus Trastuzumab: A Case Report and Review of Literature

Journal of Nanomaterials — Thu, 19 Jan 2012 15:27:25 +0100

We report a case of pCR of DCIS associated with invasive carcinoma in an HER-2 + tumor after NC plus trastuzumab despite persistence of malignant-appearing microcalcifications mammographically. A 41-year-old Caucasian female presented with a 4×4 cm mass in the right breast and a 2.5 cm right axillary node. Mammogram showed a 2.5 cm mass and a 12 cm area of linear pleomorphic, suspicious calcifications in the upper part of the breast. Core biopsy revealed invasive ductal carcinoma and DCIS associated with calcifications (ER 85%, PR 6%, Her2neu 3+ by IHC). Axillary node FNA was positive for malignancy. The patient received doxorubicin/cyclophosphamide (AC) → paclitaxel plus T with complete clinical and radiologic response but no significant cha...

Outcome Analysis of 9-Gauge MRI-Guided Vacuum-Assisted Core Needle Breast Biopsies

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. Patients with ipsilateral cancer who have additional suspicious lesions identified on MRI require careful evaluation and biopsy to exclude additional sites of cancer that may impact surgical management. (Source: American Journal of Roentgenology)

The role of sentinel lymph node biopsy in patients with ductal carcinoma in situ and microinvasion.

Surgical Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusion: Our data suggests that the risk of nodal metastasis in DCISMI may be low and questions the role of SLNB in DCISMI. We highlight the lack of data on DCISMI and risk of nodal metastasis and the need for further investigation.© 2012 The Authors. Surgical Practice © 2012 College of Surgeons of Hong Kong (Source: Surgical Practice)

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Genomic and mutational profiling of ductal carcinomas in situ and matched adjacent invasive breast cancers reveals intra‐tumour genetic heterogeneity and clonal selection

The Journal of Pathology — Wed, 18 Jan 2012 06:01:20 +0100

AbstractThe mechanisms underlying the progression from ductal carcinoma in situ (DCIS) to invasive ductal carcinoma (IDC) of the breast are yet to be fully elucidated. Several hypotheses have been put forward to explain the progression from DCIS to IDC, including the selection of a subpopulation of cancer cells with specific genetic aberrations, the acquisition of new genetic aberrations or non‐genetic mechanisms mediated by the tumour microenvironment. To determine whether synchronously diagnosed ipsilateral DCIS and IDCs have modal populations with distinct repertoires of gene copy number aberrations and mutations in common oncogenes, matched frozen samples of DCIS and IDCs were retrieved from 13 patients and subjected to microarray‐based comparative genomic hybridisation (aCGH), and...

Outcome after ipsilateral breast tumor recurrence in patients who receive accelerated partial breast irradiation

Cancer — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSIONS:With 5 years of follow‐up, APBI produced clinical outcomes and patterns of failure comparable to those achieved with whole breast irradiation. Patients who developed an IBTR after APBI had excellent 3‐year survival outcomes after salvage treatments. Cancer 2012. © 2012 American Cancer Society. (Source: Cancer)

HER‐2 pulsed dendritic cell vaccine can eliminate HER‐2 expression and impact ductal carcinoma in situ

Cancer — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSIONS:Results suggest that vaccination against HER‐2/neu is safe and well tolerated and induces decline and/or eradication of HER‐2/neu expression. These findings warrant further exploration of HER‐2/neu vaccination in estrogen‐independent breast cancer and highlight the need to target additional tumor‐associated antigens and pathways. Cancer 2011. © 2011 American Cancer Society. (Source: Cancer)

Influence of Surgical Technique on Mastectomy and Reexcision Rates in Breast-Conserving Therapy for Cancer

Computational Intelligence and Neuroscience — Mon, 16 Jan 2012 15:14:21 +0100

Conclusions. CSM is a technique that reduces reexcisions and mastectomy rates. (Source: Computational Intelligence and Neuroscience)

The Impact of Ethnicity on the, Incidence, Tumor Characteristics and Treatment of Ductal Carcinoma in Situ? An 11 Year Clinical Experience at a High Volume Teaching Hospital

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:11 +0100

(Source: Journal of Surgical Research)

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Utilization of Lymph Node Assessment in Patients with Ductal Carcinoma in Situ Undergoing Partial Mastectomy

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:11 +0100

(Source: Journal of Surgical Research)

The Impact of Neoadjuvant Chemotherapy on Wound Complication Risk After Breast Cancer Resection and Reconstruction - A Multi-Institutional Assessment

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:04 +0100

Conclusions: in this multi-institutional analysis, neoadjuvant chemotherapy was not associated with post-operative wound complication, regardless of the type of breast surgery performed. Patients and providers can be assured that receipt of neoadjuvant therapy does not increase the risk of post-operative wound complication. (Source: Journal of Surgical Research)

DEK overexpression is correlated with the clinical features of breast cancer

Pathology International — Fri, 13 Jan 2012 05:00:00 +0100

In conclusion, DEK overexpression appears to be associated with breast cancer progression and DEK may potentially be used as a breast cancer biomarker for the early diagnosis, prognostic evaluation and therapeutic target for breast cancer. (Source: Pathology International)

Must All DCIS Patients Undergo Radiation?Must All DCIS Patients Undergo Radiation?

Medscape Today Headlines — Thu, 12 Jan 2012 20:33:55 +0100

Dr. Kathy Miller reports on a new look at an old study that indicates how to identify DCIS patients at sufficiently low risk for local recurrence such that they do not need radiation after lumpectomy. Medscape Hematology-Oncology (Source: Medscape Today Headlines)

Adjuvant Hormonal Therapy Use Among Women with Ductal Carcinoma In Situ

Journal of Women — Thu, 12 Jan 2012 16:28:33 +0100

Journal of Women's Health Jan 2012, Vol. 21, No. 1: 35-42. (Source: Journal of Women)

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Mucocele-like tumor associated with ductal carcinoma in situ diagnosed as mucinous carcinoma by fine-needle aspiration cytology: report of a case

Surgery Today — Thu, 12 Jan 2012 06:43:01 +0100

We report a case of MLT associated with ductal carcinoma in situ, which was initially diagnosed as fibroadenoma by mammography and ultrasonography, and as mucinous carcinoma by fine-needle aspiration cytology. We discuss the characteristic findings of imaging and the appropriate clinical treatment of this tumor. The characteristic image first signals the possibility of this tumor, following which the diagnosis can be confirmed by pathological examination of a fully excised tumor specimen. Breast-conserving surgery is recommended because of the low risk of high-grade malignancy, even when malignancy is confirmed, and lymph node dissection may be avoided. Content Type Journal ArticleCategory Case ReportPages 1-5DOI 10.1007/s00595-011-0063-yAuthors Shoichi Kikuchi, Department of S...

Nek2A contributes to tumorigenic growth and possibly functions as potential therapeutic target for human breast cancer

Journal of Cellular Biochemistry — Tue, 10 Jan 2012 05:00:00 +0100

ConclusionsThese data suggested that Nek2A might bear a close relationship with development and progression of breast carcinoma, and highlighted its role as a novel potential biomarker for diagnosis and a possible therapeutic target for human breast cancer especially for DCIS. J. Cell. Biochem. © 2012 Wiley Periodicals, Inc. (Source: Journal of Cellular Biochemistry)

Trends in incidence and detection of advanced breast cancer at biennial screening mammography in The Netherlands: a population based study

Breast Cancer Research — Mon, 09 Jan 2012 05:00:00 +0100

Conclusion: We observed no decline in the risk of advanced breast cancer during 12 years of biennial screening mammography. The majority of these cancers could not have been prevented through earlier detection at screening. (Source: Breast Cancer Research)

Nucleobindin 2 (NUCB2) in human breast carcinoma as a potent prognostic factor. NUCB2 immunoreactivity was detected in the carcinoma cells of DCIS

Cancer Science — Sun, 01 Jan 2012 05:00:00 +0100

(Source: Cancer Science)

Diagnostic accuracy of ultrasonography-guided core needle biopsy for breast lesions.

Singapore Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: US-guided CNB is an accurate diagnostic alternative to surgical biopsy in patients with breast lesions detected via US, although the high underestimation rates in DCIS and high-risk lesions are still a concern. PMID: 22252182 [PubMed - in process] (Source: Singapore Medical Journal)

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Defining a Place for Nipple Sparing Mastectomy in Modern Breast Care: An Evidence Based Review

The Breast Journal — Sun, 01 Jan 2012 05:00:00 +0100

This article aims to critically review the indications and limitations of NSM, discuss evidence based intra‐operative protocols and to discuss ways in which radiation therapy may be incorporated in treatment planning following NSM. A comprehensive search of the scientific literature was carried out using PubMed to access all publications related to nipple sparing mastectomy. The search focused specifically on technique, current management, safety, and complications of these procedures. Keywords searched included “Nipple sparing mastectomy,”“breast conserving surgery,”“Nipple areola complex preservation” and “skin sparing mastectomy.” NSM offers an opportunity to preserve native breast envelope without mutilation of nipple‐areola complex (NAC), and avoids multiple surgic...

DNA damage induced by mammography in high family risk patients: Only one single view in screening.

Breast — Sat, 31 Dec 2011 05:00:00 +0100

Authors: Colin C, Foray N Abstract Women with high risk of breast or ovarian cancers might be more susceptible to radiation-induced cancer because most of tumor suppressor genes are also implicated in the radio-induced DNA damage repair and signaling. Recent radiobiological advances may help to re-consider the potential cellular and molecular consequences of the standard two-view mammographic screening. A major radiobiological effect exacerbated in high family risk women caused by mammographic repeated doses was pointed out on relevant cellular model (untransformed and non tumoral human breast epithelial cells): the Low and Repeated Dose (LORD) effect. In parallel, while magnetic resonance imaging (MRI) is reported to be less sensitive than mammography for detection of ductal carci...

Preoperative Breast MRI in the Surgical Treatment of Ductal Carcinoma In Situ

The Breast Journal — Fri, 30 Dec 2011 05:00:00 +0100

This study examined the accuracy of magnetic resonance imaging (MRI) for assessment of DCIS size, and evaluated the effect of preoperative breast MRI on achievement of tumor‐free surgical margins after breast‐conserving surgery (BCS). One‐hundred and fifty‐eight female patients with DCIS were identified from a prospective database: 60 patients (62 cases) had preoperative breast MRI, and 98 patients did not have MRI. The accuracy of tumor size assessed by MRI was determined by comparison with histopathologic size. All patients underwent BCS initially. The rate of involved margins after resection was compared in MRI and no‐MRI groups. The overall correlation between MRI size and histopathologic size was high (p < 0.0001). MRI assessment of size was significantly more accurat...

The role of breast MR imaging in pre-operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy

European Radiology — Thu, 29 Dec 2011 06:42:30 +0100

Conclusions Breast MR imaging is potentially useful to predict the presence of occult invasion in biopsy-proven DCIS with NMLE. Key Points • MR mammography permits more precise lesion assessment including ductal carcinoma in situ • A correct diagnosis of occult invasion before treatment is important for clinicians • This study showed the potential of MR mammography to diagnose occult invasion • Treatment and/or aggressive biopsy can be given with greater confidence • MR mammography can lead to more appropriate management of patients Content Type Journal ArticleCategory BreastPages 1-10DOI 10.1007/s00330-011-...

Atypical Hyperplasia on Core Biopsy: Is Further Surgery Needed?

The American Journal of the Medical Sciences — Tue, 27 Dec 2011 05:00:00 +0100

CONCLUSION: Upgrade rate to cancer after surgical excision was 11.3% of AH patients diagnosed on CNB. However, none of the variables are significant in determining the presence of malignancy associated with AH diagnosed by CNB. PMID: 22205116 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

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Comparative Effectiveness of Positron Emission Mammography and MRI in the Contralateral Breast of Women With Newly Diagnosed Breast Cancer

American Journal of Roentgenology — Thu, 22 Dec 2011 05:00:00 +0100

CONCLUSION. Contralateral cancer was found in 15 of 367 women (4.1%), with MRI showing 14 (93%). Eleven contralateral cancers (73%) were visible on PEM, but only three (20%) were recognized prospectively as suspicious. Lesions that are visible on PEM should be viewed as suspicious unless known to be benign by prior breast imaging or biopsy. (Source: American Journal of Roentgenology)

Psoriasin (S100A7) increases the expression of ROS and VEGF and acts through RAGE to promote endothelial cell proliferation

Breast Cancer Research and Treatment — Wed, 21 Dec 2011 20:04:56 +0100

Abstract Psoriasin (S100A7), originally identified in psoriasis, is a calcium-binding protein belonging to the multigenic S100 family. In high-grade ductal carcinoma in situ, psoriasin was identified as one of the most abundant transcripts. We have previously shown that psoriasin was induced by reactive oxygen species (ROS). Moreover, the downregulation of psoriasin by short hairpin RNA (shRNA) led to the reduced expression of vascular endothelial growth factor (VEGF) and inhibited tumor growth in vivo. The aim of the present study was to investigate whether psoriasin could have direct effects on endothelial cells. In this study we demonstrated that psoriasin increased VEGF expression in mammary epithelial cells. The treatment of endothelial cells with recombinant psoriasi...

Dynamic Breast Magnetic Resonance Imaging: Pretreatment Prediction of Tumor Response to Neoadjuvant Chemotherapy.

Clinical Genitourinary Cancer — Mon, 12 Dec 2011 05:00:00 +0100

CONCLUSION: Washout(C) may be used as a predictor for pCR in patients with breast cancer who undergo neoadjuvant chemotherapy. PMID: 22169574 [PubMed - as supplied by publisher] (Source: Clinical Genitourinary Cancer)

Diffusion-weighted imaging (b value = 1500 s/mm(2)) is useful to decrease false-positive breast cancer cases due to fibrocystic changes.

Breast Cancer — Sat, 10 Dec 2011 05:00:00 +0100

CONCLUSION: Adding ADC values calculated from DWI (b value = 1500 s/mm(2)) to BI-RADS is a useful way to improve differential diagnostic accuracy for malignant tumors and benign lesions, especially for DCIS versus fibrocystic changes, except in cases of ductal hyperplasia. PMID: 22161277 [PubMed - as supplied by publisher] (Source: Breast Cancer)

Genomic Oncotype breast cancer test to predict risk of recurrence

Hospital Management — Fri, 09 Dec 2011 00:00:00 +0100

Genomic Health's Oncotype DX has met its primary endpoint in a clinical validation study investigating patients with ductal carcinoma in situ (DCIS), a type of breast cancer. (Source: Hospital Management)

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Predicting Risk For Recurrence For Patients With DCIS Breast Cancer

Health News from Medical News Today — Thu, 08 Dec 2011 08:00:00 +0100

In a significant advance for patients with ductal carcinoma in situ, researchers have developed and prospectively validated a multigene test to identify the risk for recurrence of breast cancer. The method combines measuring tumor gene expression with a gene expression algorithm to decipher the genetic underpinnings of a patient's cancer and determine whether the individual patient should be treated with surgery (usually lumpectomy) or a combination of surgery and radiation... (Source: Health News from Medical News Today)

Oncotype DX Breast Cancer Test: Now for DCIS TooOncotype DX Breast Cancer Test: Now for DCIS Too

Medscape Today Headlines — Wed, 07 Dec 2011 22:23:25 +0100

Based on new findings, the test will likely be available soon for use in patients with ductal carcinoma in situ (DCIS). Medscape Medical News (Source: Medscape Today Headlines)

SABCS: Gene Test Predicts DCIS Recurrence Risk (CME/CE)

MedPage Today OB/GYN — Wed, 07 Dec 2011 14:43:09 +0100

SAN ANTONIO (MedPage Today) -- A multigene assay for predicting recurrence of ductal carcinoma in situ showed potential for identifying low-risk patients who can avoid radiation therapy, according to a study reported here. (Source: MedPage Today OB/GYN)

DCIS Score Predicts Risk of Ipsilateral Breast Events in Women With DCIS Regardless of Adjuvant Tamoxifen Use

Clinical Care Options Oncology - Breast Cancer — Wed, 07 Dec 2011 00:00:00 +0100

Capsule Summary - The DCIS Score was shown using samples and data from ECOG E5194 to provide independent prognostic information on the risk of IBEs beyond that attained with clinical and pathologic variables in women with DCIS who were treated with surgical resection and no radiation therapy. (Source: Clinical Care Options Oncology - Breast Cancer)

New test predicts risk for recurrence for patients with DCIS

EurekAlert! - Cancer — Tue, 06 Dec 2011 05:00:00 +0100

(American Association for Cancer Research) In a significant advance for patients with ductal carcinoma in situ, researchers have developed and prospectively validated a multigene test to identify the risk for recurrence of breast cancer. (Source: EurekAlert! - Cancer)

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SABCS: New Multigene Test Predicts Recurrence Risk for DCIS

About.com Breast Cancer — Mon, 05 Dec 2011 05:00:00 +0100

News from the 34th Annual San Antonio Breast Cancer Symposium (SABCS): Dr. Lawrence Solin presented the results of a study for a new multigene assay which has been shown to predict the risk of recurrence for patients with ductal carcinoma in situ - DCIS - a precancerous breast condition. Standard treatment for DCIS is a lumpectomy and radiation, followed by five years of hormone therapy, if the cells were estrogen-sensitive. This new test helps a doctor determine which patients need radiation to prevent a recurrence, and which may safely avoid that treatment....Read Full Post (Source: About.com Breast Cancer)

Progression of ductal carcinoma in situ to invasive breast cancer is associated with gene expression programs of EMT and myoepithelia

Breast Cancer Research and Treatment — Thu, 01 Dec 2011 19:29:06 +0100

Abstract Ductal carcinoma in situ (DCIS) is a precursor lesion that can gives rise to invasive breast cancer (IBC). It has been proposed that both the nature of the lesion and the tumor microenvironment play key roles in progression to IBC. Here, laser capture microdissected tissue from pure DCIS and pure IBC were employed to define key gene expression profiles in either the epithelial or stromal compartment associated with disease progression. Each tissue had distinct gene expression profiles, and a DCIS/IBC classifier accurately distinguished DCIS versus IBC in multiple independent data sets. However, contrary to other studies that profiled DCIS associated with invasive disease, we found that the most significant alterations in gene expression were observed in the epithe...

Nipple discharge in a screening programme: Imaging findings with pathological correlation

Australasian Radiology — Thu, 01 Dec 2011 05:00:00 +0100

SummaryBreastScreen Australia provides free mammographic screening for asymptomatic women over the age of 40, targeting women aged 50–69. Occasionally women will present to screening programmes with a history of nipple discharge, which is uncommonly associated with significant underlying breast disease. Seventy‐six women with a history of nipple discharge were recalled to BreastScreen Western Australia assessment centres from 2004 to 2008, of whom 72 were recalled primarily for their symptoms. Thirty‐six of these patients had pathology investigations, including 18 nipple discharge smears, 17 fine needle aspirations, 11 core biopsies and eight surgical biopsies or therapeutic resections. The biopsies found 11 intraduct papillomas and one invasive ductal carcinoma with ductal carcinoma...

Cyclooxygenase-2 and human epidermal growth factor receptor type 2 (HER-2) expression simultaneously in invasive and in situ breast ductal carcinoma.

Sao Paulo Medical Journal — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSIONS: Our findings provide evidence that HER-2 and COX-2 regulate each other. PMID: 22249792 [PubMed - in process] (Source: Sao Paulo Medical Journal)

Surgical Excision of Benign Papillomas Diagnosed with Core Biopsy: A Community Hospital Approach

Clinical and Developmental Immunology — Wed, 30 Nov 2011 23:54:38 +0100

Our goal was to assess the value of surgical excision of benign papillomas of the breast diagnosed on percutaneous core biopsy by determining the frequency of upgrade to malignancies and high risk lesions on a final surgical pathology. We reviewed 67 patients who had biopsies yielding benign papilloma and underwent subsequent surgical excision. Surgical pathology of the excised lesions was compared with initial core biopsy pathology results. 54 patients had concordant benign core and excisional pathology. Cancer (ductal carcinoma in situ and invasive ductal carcinoma) was diagnosed in five (7%) patients. Surgery revealed high-risk lesions in 8 (12%) patients, including atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ. Cancer and high risk les...

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Expression and mutational status of RON in neoplastic lesions of the breast: analysis of MSP/RON signaling in ductal carcinoma in situ and invasive ductal carcinoma

APMIS — Mon, 28 Nov 2011 05:00:00 +0100

Ren XL, Daa T, Yada N, Kashima K, Fujitomi Y, Yokoyama S. Expression and mutational status of RON in neoplastic lesions of the breast: analysis of MSP/RON signaling in ductal carcinoma in situ and invasive ductal carcinoma. APMIS 2011.Recepteur d’origine nantais (RON) is a receptor tyrosine kinase closely related to MET and involved in tumorigenesis. We investigated the roles of aberrations in RON and its ligand, macrophage‐stimulating protein (MSP), in invasive ductal carcinoma (IDC, n = 81), ductal carcinoma in situ (DCIS, n = 26), and in benign lesions (n = 20) of mammary gland. Expression of RON and MSP was evaluated by immunohistochemistry and the mutational status of a region containing the proteolytic cleavage site in exon 1 and each exon of the kinase domain (exon 1...

Non-receptor tyrosine kinase 2 reaches its lowest expression levels in human breast cancer during regional nodal metastasis

Clinical and Experimental Metastasis — Thu, 24 Nov 2011 17:52:36 +0100

Abstract Almost half of breast Ductal Carcinoma in situ are likely to remain non threatening in situ lesions with no invasion to the surrounding stroma and no metastases. The majority of focal disruptions in myoepithelial (ME) cell layers indicative of invasion onset were found to be overlying epithelial cell clusters with no or substantially reduced estrogen receptor α (ERα) expression. Here we report the down-regulation of tyrosine kinase-2 (TYK2) and up-regulation of strumpellin expression, among other proteins in ERα(−) cells located at disrupted ME layers compared to adjacent ERα(+) cells overlying an intact myoepithelial layer. ERα(+) and ERα(−) cells were microdissected from the same in vivo human breast cancer tissues, proteins were extracted and separate...

Six-Year Analysis of Treatment-Related Toxicities in Patients Treated with Accelerated Partial Breast Irradiation on the American Society of Breast Surgeons MammoSite Breast Brachytherapy Registry Trial

Annals of Surgical Oncology — Wed, 23 Nov 2011 16:40:52 +0100

Conclusions Treatment-related toxicities 6 years after treatment with APBI using the MammoSite device are similar to those reported with other forms of APBI with similar follow-up. Content Type Journal ArticleCategory Breast OncologyPages 1-7DOI 10.1245/s10434-011-2133-1Authors A. J. Khan, Department of Radiation Oncology, Cancer Institute of New Jersey, New Brunswick, NJ, USADouglas Arthur, Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA, USAF. Vicini, Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, USAP. Beitsch, Department of Surgery, Dallas Breast Center, Dallas, TX, USAH. Kuerer, Department of Surgery, M. D. Anderson Cancer Center, Houston, TX, USAS. Goyal, Department of Radiation Oncology, Cancer...

BI-RADS-MRI terminology and evaluation of intraductal carcinoma and ductal carcinoma in situ.

Breast Cancer — Wed, 23 Nov 2011 05:00:00 +0100

Authors: Tozaki M Abstract There has been dramatic progress in MRI technology during the past 20 years, and the rate of detection and diagnostic accuracy in regard to intraductal carcinoma and ductal carcinoma in situ (DCIS) have been increasing. First, we present MRI images of intraductal carcinomas and the terminology in the second edition of the BI-RADS-MRI to describe them. Next, we examined the data in our institution in regard to the following: (1) the DCIS detection rate, (2) the proportions of breast cancer and DCIS in MR-guided vacuum-assisted biopsies (VAB), (3) evaluation of the extent of intraductal carcinoma, and (4) diagnosis of extension of intraductal carcinoma into the nipple. MR images were acquired by performing a 1-min interval dynamic study with a 1.5-T MR sca...

Structural Estimates of Treatment Effects on Outcomes Using Retrospective Data: An Application to Ductal Carcinoma In Situ

Medical Care Research and Review — Mon, 21 Nov 2011 05:00:00 +0100

Analysis of observational cohort data is subject to bias from unobservable risk selection. The authors compared econometric models and treatment effectiveness estimates using the linked Surveillance, Epidemiology, and End Results (SEER)–Medicare claims data for women diagnosed with ductal carcinoma in situ. Treatment effectiveness estimates for mastectomy and breast-conserving surgery (BCS) with or without radiotherapy were compared using three different models: simultaneous-equations model, discrete-time survival model with unobserved heterogeneity (frailty), and proportional hazards model. Overall trends in disease-free survival (DFS), or time to first subsequent breast event, by treatment are similar regardless of the model, with mastectomy yielding the highest DFS over 8 years of...

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Imaging tumor vascularization for detection and diagnosis of breast cancer.

Technology in Cancer Research and Treatment — Sat, 19 Nov 2011 16:18:12 +0100

Authors: Heijblom M, Klaase JM, van den Engh FM, van Leeuwen TG, Steenbergen W, Manohar S Abstract Breast cancer is one of the major causes of morbidity and mortality in western women. Current screening and diagnostic imaging modalities, like x-ray mammography and ultrasonography, focus on morphological changes of breast tissue. However, these techniques still miss some cancers and often falsely detect cancer. The sensitivity and specificity for detecting the disease can probably be improved by focusing on the consequences of tumor angiogenesis: the increased microvessel density with altered vascular characteristics. In this review, various techniques for imaging breast tumor vasculature are discussed. Dynamic contrast enhanced magnetic resonance imaging is the most-used imaging mo...

Effect of Observing Change from Comparison Mammograms on Performance of Screening Mammography in a Large Community-based Population [Breast Imaging]

Radiology — Thu, 17 Nov 2011 05:00:00 +0100

Conclusion: Performance is affected when change from comparison mammograms is noted. Without change, sensitivity is low and specificity is high. With change, sensitivity is high, with a high false-positive rate (low specificity). Further work is needed to appreciate changes that might indicate cancer and to identify changes that are likely not indicative of cancer. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110653/-/DC1 (Source: Radiology)

Comparison of the clinical performance of three digital mammography systems in a breast cancer screening programme.

The British Journal of Radiology — Thu, 17 Nov 2011 05:00:00 +0100

This study compares the clinical performance of three digital mammography system types in a breast cancer screening programme. 28 digital mammography systems from three different vendors were included in the study. The retrospective analysis included 238 182 screening examinations of women aged between 50 and 64 years over a three-year period. All images were double read and assigned a result according to a 5-point rating scale to indicate the probability of cancer. Women with a positive result were recalled for further assessment imaging and biopsy if necessary. Clinical performance in terms of cancer detection rate was analysed and the results presented. No statistically significant difference was found between the three different mammography systems in a population-based screening progr...

Reduced expression of activin receptor-like kinase 7 in breast cancer is associated with tumor progression

Medical Oncology — Tue, 15 Nov 2011 16:50:00 +0100

Abstract To explore the clinical implication of activin receptor-like kinase 7 (ALK7) expression in breast cancer, we evaluated its protein level in six kinds of human breast tissue samples, including adjacent normal tissues, adenosis, breast fibroadenoma, ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), and lymph node metastases (LNM). Immunohistochemical analyses showed that ALK7 was more frequently and much more intensely expressed in adjacent normal tissues, adenosis, and fibroadenoma tissues than in malignant tissues (DCIS, IDC, and LNM). Furthermore, the ALK7 expression in primary tumors and the corresponding LNM was evaluated in parallel samples from 60 patients with IDC. Results showed that the ALK7 expression status in primary tumors and LNM was c...

Re: Long-term Outcomes of Invasive Ipsilateral Breast Tumor Recurrences After Lumpectomy in NSABP B-17 and B-24 Randomized Clinical Trials for DCIS

JNCI — Tue, 15 Nov 2011 05:00:00 +0100

(Source: JNCI)

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Paget Disease of the Breast: Mammographic, US, and MR Imaging Findings with Pathologic Correlation [Breast Imaging]

Radiographics recent issues — Mon, 14 Nov 2011 05:00:00 +0100

Paget disease is a rare malignancy of the breast characterized by infiltration of the nipple epidermis by adenocarcinoma cells. The clinical features of Paget disease are characteristic and should increase the likelihood of the diagnosis being made. An important point is that more than 90% of cases of Paget disease are associated with an additional underlying breast malignancy. Paget disease is frequently associated with ductal carcinoma in situ (DCIS) in the underlying lactiferous ducts of the nipple-areolar complex; it may even be associated with DCIS or invasive breast cancer elsewhere in the breast, at least 2 cm from the nipple-areolar complex. Nevertheless, mammographic findings may be negative in up to 50% of cases. Magnetic resonance (MR) imaging can be useful in patients with Page...

Expression and role of fibroblast activation protein-alpha in microinvasive breast carcinoma

Diagnostic Pathology — Tue, 08 Nov 2011 05:00:00 +0100

Conclusions: This study provides the first evidence that immunostaining with FAP-alpha and Calponin can serve as a novel marker for pathologically diagnosing whether DCIS has microinvasion. (Source: Diagnostic Pathology)

Cancerization of lobules: correlation between mammography and histological findings

Radiologia Brasileira — Fri, 04 Nov 2011 05:54:29 +0100

CONCLUSION: In our cohort, the mammographic evaluation of patients with DCIS presenting cancerization of lobules demonstrated clusters of microcalcifications in a lobular distribution. Although clusters of round calcifications are typically associated with a benign process, cancerization of lobules by DCIS may produce a similar pattern, thus mimicking a benign condition. (Source: Radiologia Brasileira)

Loss of interferon regulatory factor 5 (IRF5) expression in human ductal carcinoma correlates with disease stage and contributes to metastasis

Breast Cancer Research — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions: IRF5 is an important tumor suppressor that regulates multiple cellular processes (i.e. growth, response to DNA damage, and invasion/metastasis) involved in the conversion of normal mammary epithelial cells to tumor epithelial cells with metastatic potential. (Source: Breast Cancer Research)

Identification of copy number alterations associated with the progression of DCIS to invasive ductal carcinoma

Breast Cancer Research and Treatment — Thu, 03 Nov 2011 16:55:58 +0100

Abstract Ductal carcinoma in situ (DCIS) is a non-obligate precursor to invasive ductal carcinoma (IDC). Annotation of the genetic differences between the two lesions may assist in the identification of genes that promote the invasive phenotype. Synchronous DCIS and IDC cells were microdissected from FFPE tissue and analysed by molecular inversion probe (MIP) copy number arrays. Matched IDC and DCIS showed highly similar copy number profiles (average of 83% of the genome shared) indicating a common clonal origin although there is evidence that the DCIS continues to evolve in parallel with the co-existing IDC. Four chromosomal regions of loss (3q, 6q, 8p and 11q) and four regions of gain (5q, 16p, 19q and 20) were recurrently affected in IDC but not in DCIS. CCND1 and MYC s...

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Some clarity in the management of DCIS in breast cancer screening

Journal of Medical Screening — Tue, 01 Nov 2011 04:00:00 +0100

(Source: Journal of Medical Screening)

ACR Appropriateness Criteria® Ductal Carcinoma in Situ

The Breast Journal — Tue, 01 Nov 2011 04:00:00 +0100

This article reviews the existing scientific evidence, the controversies surrounding local management, and clinical guidelines for DCIS based on the group consensus by the ACR Breast Expert Panel. The American College of Radiology Appropriateness Criteria are evidence‐based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer‐reviewed journals and the application of a well established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatm...

Breast Cancer Subtype-Specific Interactions with the Microenvironment Dictate Mechanisms of Invasion

Cancer Research — Sun, 30 Oct 2011 04:00:00 +0100

Most ductal breast carcinoma cells are weakly invasive in vitro and in vivo, suggesting that components of their microenvironment may facilitate a transition from in situ to invasive stages during progression. Here, we report that coculture of mammary fibroblasts specifically triggers invasive behavior in basal-type breast cancer cells through a ligand independent mechanism. When cultured alone in organotypic culture, both basal- and luminal-type breast cancer cells formed noninvasive spheroids with characteristics of ductal carcinoma in situ (DCIS). In contrast, when cocultured with mammary fibroblasts, basal-type spheroids exhibited invasive character whereas the luminal-type spheroids retained a benign and noninvasive duct-like architecture. Real-time imaging and functional studies reve...

Prognostic value of positive human epidermal growth factor receptor 2 status and negative hormone status in patients with T1a/T1b, lymph node‐negative breast cancer

Cancer — Tue, 25 Oct 2011 04:00:00 +0100

CONCLUSIONS:The current results indicated that patients with T1a/T1b, lymph node‐negative BC have a low risk of distant and local recurrence, but younger age is a significant risk factor for events occurrence. Young women with HER2‐positive and HR‐negative status have a significant risk of distant recurrence and should be considered for future clinical trials with anti‐HER2 adjuvant therapy. Cancer 2011;. © 2011 American Cancer Society. (Source: Cancer)

Better exercise adherence after treatment for cancer (BEAT Cancer) study: Rationale, design, and methods

Contemporary Clinical Trials — Mon, 24 Oct 2011 04:00:00 +0100

Abstract: Most breast cancer survivors do not engage in regular physical activity. Our physical activity behavior change intervention for breast cancer survivors significantly improved physical activity and health outcomes post-intervention during a pilot, feasibility study. Testing in additional sites with a larger sample and longer follow-up is warranted to confirm program effectiveness short and longer term. Importantly, the pilot intervention resulted in changes in physical activity and social cognitive theory constructs, enhancing our potential for testing mechanisms mediating physical activity behavior change. Here, we report the rationale, design, and methods for a two-site, randomized controlled trial comparing the effects of the BEAT Cancer physical activity behavior change interv...

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What is the significance of flat epithelial atypia and what are the management implications?

Journal of Clinical Pathology — Sat, 22 Oct 2011 04:00:00 +0100

Conclusion The presence of FEA on core biopsy warrants further tissue sampling to ensure concomitant malignancy is not missed. Sampling with VAB provides sufficient tissue for histopathological evaluation, reducing the need for surgical biopsy. It is important that the utilisation of VAB is incorporated into a safe patient management pathway with careful multidisciplinary team discussion to ensure radiological–pathological concordance. (Source: Journal of Clinical Pathology)

Non-invasive Detection of Breast Cancer Lymph Node Metastasis using Carbonic Anhydrases IX and XII Targeted Imaging Probes.

Clinical Cancer Research — Thu, 20 Oct 2011 04:00:00 +0100

CONCLUSION: These imaging probes have potential for non-invasive staging of breast cancer in the clinic and elimination of unneeded surgery, which is costly and associated with morbidities. PMID: 22016510 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

Screening Breast MR Imaging in Women with a History of Lobular Carcinoma in Situ [Breast Imaging]

Radiology — Wed, 19 Oct 2011 04:00:00 +0100

Conclusion: MR imaging is a useful adjunct modality with which to screen women with a history of LCIS at high-risk of developing breast cancer, resulting in a 4.5% incremental cancer detection rate. Sensitivity in the detection of breast cancers with a combination of MR imaging and mammography was higher than sensitivity of either modality alone. © RSNA, 2011 (Source: Radiology)

Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

Journal of General Internal Medicine — Tue, 18 Oct 2011 05:48:49 +0100

CONCLUSIONS Annual mammography among women age 65 to 85 with DCIS declines as women get further from diagnosis. Interventions should focus on reducing disparities in the use of initial surveillance mammography, and increasing surveillance over time. Content Type Journal ArticleCategory Original ResearchPages 1-6DOI 10.1007/s11606-011-1918-zAuthors Phyllis Brawarsky, Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women’s Hospital, 1620 Tremont Street, Boston, MA 02120-1613, USABridget A. Neville, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USAGarrett M. Fitzmaurice, Laboratory for Psychiatric Biostatistics, McLean Hospital and Harvard Medical School, Belmont, USAMichael J. Hassett, Center for Outcomes and...

Impact of digital mammography in the detection and management of microcalcifications.

Radiologia — Tue, 18 Oct 2011 04:00:00 +0100

CONCLUSION: Direct digital mammography has improved the detection of microcalcifications, increasing the number of DCIS diagnosed without decreasing the positive predictive value of the invasive procedures indicated for microcalcifications. However, direct digital mammography has had a negative effect by increasing the recall rate and indication for short-term follow-up, possibly due to the difficulty of comparing the findings with those of earlier analog mammograms. PMID: 22015223 [PubMed - as supplied by publisher] (Source: Radiologia)

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Comparative Effectiveness of Digital Versus Film-Screen Mammography in Community Practice in the United States: A Cohort Study.

Annals of Internal Medicine — Tue, 18 Oct 2011 04:00:00 +0100

Conclusion: Overall, cancer detection with digital or film-screen mammography is similar in U.S. women aged 50 to 79 years undergoing screening mammography. Women aged 40 to 49 years are more likely to have extremely dense breasts and estrogen receptor-negative tumors; if they are offered mammography screening, they may choose to undergo digital mammography to optimize cancer detection. Primary Funding Source: National Cancer Institute. PMID: 22007043 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)

Usefulness of breast-specific gamma imaging as an adjunct modality in breast cancer patients with dense breast: a comparative study with MRI

Annals of Nuclear Medicine — Mon, 17 Oct 2011 16:03:52 +0100

Conclusion BSGI showed an equivocal sensitivity and a high specificity compared to MRI in the diagnosis of breast lesions. In addition, BSGI had a good sensitivity in discriminating breast cancers ≤1 cm. The results of this study suggest that BSGI could play a crucial role as an adjunctive imaging modality which can be used to evaluate breast cancer patients with dense breasts. Content Type Journal ArticleCategory Original articlePages 1-7DOI 10.1007/s12149-011-0544-5Authors Bom Sahn Kim, Departments of Nuclear Medicine, Mokdong Hospital, Ewha Womans University School of Medicine, 911–1 Mok-Dong, Yangchun-Ku, Seoul, 158–710 Korea Journal Annals of Nuclear MedicineOnline ISSN 1864-6433Print ISSN 0914-7187 (Source: Annals of Nuclear Medicine)

The ADAMTS1 Protease Gene Is Required for Mammary Tumor Growth and Metastasis.

The American Journal of Pathology — Wed, 12 Oct 2011 04:00:00 +0100

Authors: Ricciardelli C, Frewin KM, Tan ID, Williams ED, Opeskin K, Pritchard MA, Ingman WV, Russell DL Abstract A disintegrin and metalloprotease with thrombospondin motifs protein 1 (ADAMTS1) is a protease commonly up-regulated in metastatic carcinoma. Its overexpression in cancer cells promotes experimental metastasis, but whether ADAMTS1 is essential for metastatic progression is unknown. To address this question, we investigated mammary cancer progression and spontaneous metastasis in the MMTV-PyMT mouse mammary tumor model in Adamts1 knockout mice. Adamts1(-/-)/PyMT mice displayed significantly reduced mammary tumor and lung metastatic tumor burden and increased survival, compared with their wild-type and heterozygous littermates. Histological examination revealed an increase...

Variation between hospitals in surgical margins after first breast-conserving surgery in the Netherlands

Breast Cancer Research and Treatment — Mon, 10 Oct 2011 15:06:03 +0100

Abstract Surgical margin status after first breast-conserving surgery (BCS) is used as a quality indicator of breast cancer care in the Netherlands. The aim is to describe the variation in surgical margin status between hospitals. 7,345 patients with DCIS or invasive cancer (T1-2,N0-1,M0) diagnosed between July 1, 2008, and June 30, 2009, who underwent BCS as first surgery, were selected from the Netherlands Cancer Registry. Patients were treated in 96 hospitals. Maximum target values were 30% ‘focally positive’ or ‘more than focally positive’ for DCIS and 10% ‘more than focally positive’ for invasive carcinoma. Results per hospital are presented in funnel plots. For invasive carcinoma, multivariate logistic regression was used to adjust for case mix. Overall 2...

Coexisting ductal carcinoma in situ independently predicts lower tumor aggressiveness in node-positive luminal breast cancer

Medical Oncology — Fri, 07 Oct 2011 16:00:29 +0100

Abstract Primary breast invasive ductal carcinoma coexisting with ductal carcinoma in situ (IDC-DCIS) is characterized by lower proliferation rate and metastatic propensity than size-matched pure IDC. IDC-DCIS is also more often ER-positive, PR-positive and/or HER2-positive. This analysis aims to clarify whether the presence of coexisting DCIS in IDC affects tumor aggressiveness in various biological subtypes of breast cancer, respectively. Tumor data obtained from 1,355 consecutive female patients undergoing upfront surgery for primary breast cancer were analyzed retrospectively; 196 patients with pure DCIS were excluded. Based on evidence that immunohistochemistry (IHC) provides a reasonable approximation of molecular phenotypes, the tumor samples were divided into 4 gro...

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Prospective Evaluation of the Nipple–Areola Complex Sparing Mastectomy for Risk Reduction and for Early-Stage Breast Cancer

Annals of Surgical Oncology — Fri, 07 Oct 2011 05:45:15 +0100

Conclusions NSM is technically feasible in select patients, with a low risk for NAC removal resulting from necrosis or intraoperative detection of cancer, and preserves sensation and QOL. Thorough pathologic assessment of the NAC base is critical to ensure disease eradication. Content Type Journal ArticleCategory Breast OncologyPages 1-8DOI 10.1245/s10434-011-2099-zAuthors Jamie L. Wagner, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USARegina Fearmonti, Department of Surgery, Duke University, Durham, USAKelly K. Hunt, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USARosa F. Hwang, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston,...

Palpable ductal carcinoma in situ of the breast

International Journal of Surgery — Thu, 06 Oct 2011 22:52:31 +0100

The aim of this study was to correlate the clinical, radiological and histopathological characteristics of patients presenting with palpable pure Ductal Carcinoma in Situ (pDCIS). (Source: International Journal of Surgery)

MRI findings of cancers preoperatively diagnosed as pure DCIS at core needle biopsy.

Acta Radiologica — Mon, 03 Oct 2011 04:00:00 +0100

ConclusionEnhanced MRI provided informative morphology and size features that might help to predict the underestimation of invasiveness in preoperative biopsy-proven DCIS. PMID: 21969708 [PubMed - as supplied by publisher] (Source: Acta Radiologica)

A Mouse Mammary Tumor Virus env-Like Exogenous Sequence Is Strictly Related to Progression of Human Sporadic Breast Carcinoma.

The American Journal of Pathology — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Mazzanti CM, Al Hamad M, Fanelli G, Scatena C, Zammarchi F, Zavaglia K, Lessi F, Pistello M, Naccarato AG, Bevilacqua G Abstract A viral etiology of human breast cancer (HBC) has been postulated for decades since the identification of mouse mammary tumor virus (MMTV). The detection of MMTV env-like exogenous sequences (MMTVels) in 30% to 40% of invasive HBCs increased attention to this hypothesis. Looking for MMTVels during cancer progression may contribute to a better understanding of their role in HBC. Herein, we analyzed HBC preinvasive lesions for the presence of MMTVels. Samples were obtained by laser microdissection of FFPE tissues: 20 usual-type ductal hyperplasias, 22 atypical ductal hyperplasias (ADHs), 49 ductal carcinomas in situ (DCISs), 20 infiltrating ductal ...

Improving breast cancer care through a regional quality collaborative

Surgery — Sat, 01 Oct 2011 04:00:00 +0100

We present initial results from our analysis of institutional variation in surgical and core needle biopsy use within a regional breast cancer quality collaborative.Methods: Established in 2006, the Michigan Breast Oncology Quality Initiative (MiBOQI) consists of 18 hospitals collecting data on breast cancer care using the National Comprehensive Cancer Centers Network (NCCN) Oncology Outcomes Database Project platform to analyze and compare breast cancer practices and outcomes amongst member institutions. Institutional review board approval is obtained at each site. Data are submitted electronically to the NCCN and analyzed for concordance with practice guidelines. Aggregate and blinded data are shared with project directors and institutions at collaborative meetings, and ongoing practice ...

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Sampling of secondary margins decreases the need for re-excision after partial mastectomy

Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Background: We analyzed factors that influenced the need for re-excision after partial mastectomy.Methods: We conducted a retrospective study of 470 breast cancer patients treated with partial mastectomy with main outcome measures of re-excision, conversion to mastectomy, and recurrence.Results: Of 470 patients, 146 (31%) underwent re-excision for inadequate margins and 42 (8.9%) required mastectomy. Twelve (2.6%) patients had local recurrence of disease with a mean follow-up of 4.2 years. Factors found on multivariate analysis increasing the likelihood of re-excision include wire localization (2.4-fold), tumor or ductal carcinoma in situ (DCIS) close to the margins ( (Source: Surgery)

[Primary systemic therapy in breast cancer patients (2007-2010)].

Magyar Sebeszet — Sat, 01 Oct 2011 04:00:00 +0100

Conclusion: NA therapy was effective primarily in decreasing tumour size; however, it was less effective on axillary lymph node metastases. Due to the presence of residual DCIS component, the volume of resection could not have been decreased as much as down-staging of the invasive cancer have permitted. PMID: 21997525 [PubMed - in process] (Source: Magyar Sebeszet)

Abnormal expression of Nek2 and β‐catenin in breast carcinoma: clinicopathological correlations

Histopathology — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions: This study suggests that abnormal expression of Nek2 and β‐catenin might be one of the mechanisms of tumorigenesis, especially of abnormal tumour proliferation. They may represent new potential targets for therapeutic intervention. (Source: Histopathology)

Massive myoepithelial proliferation (myoepitheliosis) with lumpy deposits of basement membrane material closely associated with apocrine adenosis and ductal carcinoma in situ of the breast

Pathology International — Thu, 29 Sep 2011 17:59:05 +0100

(Source: Pathology International)

The Incidence and Predictor of Lymph Node Metastasis for Patients with T1mi Breast Cancer Who Underwent Axillary Dissection and Breast Irradiation: An Institutional Analysis

Japanese Journal of Clinical Oncology — Wed, 28 Sep 2011 04:00:00 +0100

Conclusions A significant rate of axillary metastases occurred in the patients with T1mi breast carcinoma in this study. The comedo subtype of ductal carcinoma in situ, a high histologic grade, the presence of necrosis and the Van Nuys group 3 were significant predictors of axillary lymph node metastasis in patients with T1mi breast cancer. Thus, the patients with T1mi breast disease are indicated to a careful evaluation of axillary lymph node metastasis, if they have the earlier-mentioned unfavorable factors. (Source: Japanese Journal of Clinical Oncology)

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Comparison of the effects of genetic and environmental risk factors on IN SITU and invasive ductal breast cancer

International Journal of Cancer — Tue, 27 Sep 2011 04:00:00 +0100

AbstractLittle is known about the aetiology of in situ ductal breast cancer (DCIS) or what influences its possible progression to invasive ductal disease. Comparison of risk factors for DCIS and invasive ductal cancer may throw some light on these issues. We estimated relative risks for DCIS and invasive ductal breast cancer according to 12 genetic and 8 environmental risk factors among 1.1 million postmenopausal women in a large prospective UK study. There was no strong evidence of a different association with DCIS versus invasive ductal cancer for any of the 12 susceptibility loci examined. We also found similar associations of age at menarche, age at first birth, parity, age at menopause, family history of breast cancer and use of hormone replacement therapy (HRT) with DCIS and invasive...

Coexistence of pregnancy-like and cystic hypersecretory hyperplasia with invasive lobular carcinoma.

Onkologie — Sat, 24 Sep 2011 10:36:06 +0100

Conclusions: The present case documents the previously unreported coexistence of PLH/CHH accompanied by multifocal lobular carcinoma. Extensive examination, including an excisional biopsy, is prudent if a needle core biopsy reveals a PLH/CHH lesion. PMID: 21934345 [PubMed - in process] (Source: Onkologie)

Wanda Sykes Takes Her Breast Cancer Seriously

About.com Breast Cancer — Thu, 22 Sep 2011 04:00:00 +0100

Wanda Sykes Photo © Getty Images/Frederick M. Brown Outspoken comedian Wanda Sykes busted out of the breast cancer closet during an interview with Ellen DeGeneres. Sykes said that her diagnosis of DCIS - ductal carcinoma in situ - was discovered during breast reduction surgery that she had in February of this year. Sykes said that her natural breasts were "real big," and had been causing back pain. Her original intention had been to lighten her burden, but that plan had not included total removal of both breasts. When routine pathology tests were done on the tissue removed during breast reduction surgery...Read Full Post (Source: About.com Breast Cancer)

Is There a Low-Grade Precursor Pathway in Breast Cancer?

Annals of Surgical Oncology — Wed, 21 Sep 2011 05:54:13 +0100

Conclusions These data do not support a low-grade precursor pathway characterized by LCIS and LG-DCIS. ER/PR and HER2 status have a high rate of concordance between in situ and subsequent invasive lesions. Additional studies of metachronous in situ and invasive lesions are needed to better understand pathways of breast tumorigenesis. Content Type Journal ArticleCategory Breast OncologyPages 1-7DOI 10.1245/s10434-011-2053-0Authors Tari A. King, Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USARita A. Sakr, Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USAShirin Muhsen, Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USAVictor P. Andrade, Brea...

Radial scar without associated atypical epithelial proliferation on image-guided 14-gauge needle core biopsy: Analysis of 49 cases from a single-centre and review of the literature.

Breast — Wed, 21 Sep 2011 04:00:00 +0100

Authors: Bianchi S, Giannotti E, Vanzi E, Marziali M, Abdulcadir D, Boeri C, Livi L, Orzalesi L, Sanchez LJ, Susini T, Vezzosi V, Nori J Abstract The purpose of this study was to evaluate the reliability of image-guided 14-gauge needle core biopsy in the diagnosis of radial scar without associated atypical epithelial proliferation, by comparison with definitive histological diagnosis on surgical excision. The records of 8792 consecutive image-guided 14-gauge needle core biopsy of the breast performed from January 1996 to December 2009 were reviewed. Forty-nine cases of radial scar without associated atypical epithelial proliferation were identified and compared with definitive histological diagnosis on surgical excision. The definitive histological diagnosis on surgical excision co...

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Cancellation of MR Imaging-guided Breast Biopsy Due to Lesion Nonvisualization: Frequency and Follow-Up [Breast Imaging]

Radiology — Mon, 19 Sep 2011 04:00:00 +0100

Conclusion: MR imaging-guided breast biopsy was canceled due to lesion nonvisualization in 8% of the patients. Although the cancer detection rate among the lesions for which biopsy was canceled is low (95% CI: 0%, 9%), short-term follow-up MR imaging is prudent. © RSNA, 2011 (Source: Radiology)

Misleading chest X-ray findings following the insertion of a breast expander

Journal of Plastic, Reconstructive and Aesthetic Surgery — Mon, 19 Sep 2011 04:00:00 +0100

A 57 year old woman was diagnosed with a left sided high grade ductal carcinoma in situ (DCIS). She underwent a skin sparing mastectomy and immediate implant only reconstruction at Addenbrooke’s Hospital, Cambridge. (Source: Journal of Plastic, Reconstructive and Aesthetic Surgery)

Effects of short-term estrogen treatment on the progression of N-methyl-N-nitrosourea-induced premalignant mammary lesions in female Lewis rats

Medical Molecular Morphology — Thu, 15 Sep 2011 15:52:10 +0100

Abstract We studied the effects of short-term estrogen treatment (STET) on the progression of mammary lesions from ductal hyperplasia (DH) through ductal carcinoma in situ (DCIS) to invasive ductal carcinoma (IDC) in the N-methyl-N-nitrosourea (MNU)-induced rat mammary carcinogenesis model. Three-week-old female Lewis rats (n = 40) received an intraperitoneal injection of MNU (50 mg/kg). Three weeks later, a 3-week-release, 0.25-mg, 17β-estradiol pellet was subcutaneously implanted for 2 weeks in 20 rats (STET); the remaining 20 rats did not receive the estradiol pellets (age-matched control). All rats were killed at 12 weeks of age, and their abdominal-inguinal mammary glands were histologically examined. The incidence and multiplicity of DHs were similar between groups (S...

Chromosomal aberrations as detected by array comparative genomic hybridization in early low‐grade intraepithelial neoplasias of the breast

Histopathology — Sat, 10 Sep 2011 04:00:00 +0100

Conclusions: The results show concurrent chromosomal aberrations of 1q gains and 16q losses in several cases with coexisting LIN and DIN1a. These aberrations are known to be common in low‐grade invasive (ductal and lobular) carcinomas as well as in more advanced (conventional) types of low‐grade ductal intraepithelial neoplasia (DIN) (low‐grade ductal carcinoma in situ). Our results raise the possibility of similar molecular‐genetic pathways in coexisting LIN and low‐grade flat DIN. (Source: Histopathology)

Nuclear PARP-1 protein overexpression is associated with poor overall survival in early breast cancer.

Ann Oncol — Fri, 09 Sep 2011 04:00:00 +0100

CONCLUSIONS: Nuclear PARP-1 is overexpressed during the malignant transformation of the breast, particularly in triple-negative tumors, and independently predicts poor prognosis in operable invasive breast cancer. PMID: 21908496 [PubMed - as supplied by publisher] (Source: Ann Oncol)

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Adjuvant Hormonal Therapy Use Among Women with Ductal Carcinoma In Situ

Journal of Women — Thu, 08 Sep 2011 16:14:20 +0100

Journal of Women's Health , Vol. 0, No. 0. (Source: Journal of Women)

Detection of Slit2 promoter hypermethylation in tissue and serum samples from breast cancer patients

Virchows Archiv — Tue, 06 Sep 2011 05:47:18 +0100

Abstract Promoter hypermethylation has been shown to be a common mechanism for inactivation of tumor suppressor genes in breast cancer. The aim of this study was to investigate the prevalence of Slit2 promoter hypermethylation in both the tumor and serum samples of breast cancer patients with ductal carcinoma in situ (DCIS) or invasive breast carcinoma (IBC). The methylation status of Slit2 was investigated in 210 tissue samples (15 breast with no pathological findings, 26 DCIS, and 169 IBC samples) and 123 corresponding serum samples (15 breast with no pathological findings, 26 DCIS, and 82 IBC samples) using methylation-specific polymerase chain reaction. Immunohistochemical staining for Slit2 was also performed using tissue microarray blocks to determine whether Slit2 p...

Comparative analysis of loss of heterozygosity and expression profi le in normal tissue, DCIS and invasive breast cancer

Clinical and Translational Oncology — Sun, 04 Sep 2011 10:50:35 +0100

Conclusion We have confirmed that some of the molecular characteristics of DCIS are identical to those of invasive carcinoma. This approach could lead to the identification of molecular markers as indicators for the potential development of DCIS into invasive carcinoma or identification of DCIS subgroups with latent invasion. Content Type Journal ArticleCategory Research ArticlesPages 652-655DOI 10.1007/s12094-011-0710-1Authors Michal Zikan, Oncogynecologic Center Department of Obstetrics and Gynecology, Charles University in Prague First Faculty of Medicine and General University Hospital, Apolinarska 18, 128 00 Prague 2, Czech RepublicJan Bohm, Department of Obstetrics and Gynecology, MEDINOS Clinic, Sonneberg, GermanyDavid Pavlista, Oncogynecologic Center Departm...

Incidental finding of synchronous bilateral ductal carcinoma in situ associated with gynecomastia in a 15-year-old obese boy: case report and review of the literature

Journal of Pediatric Surgery — Thu, 01 Sep 2011 04:00:00 +0100

Abstract: Carcinoma of the breast is rarely encountered in the male population and is even less prevalent in the pediatric male population. Studies have suggested an association between male breast carcinoma and gynecomastia, but conflicting results have been shown. Only 3 cases of carcinoma in situ associated with bilateral gynecomastia during puberty have been described in the literature. Here, we present the case of a 15-year-old boy with bilateral gynecomastia who was found to have synchronous bilateral ductal carcinoma in situ. (Source: Journal of Pediatric Surgery)

What are safe margins of resection for invasive and in situ breast cancer?

Oncology (Williston Park, N.Y.) — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Revesz E, Khan SA Abstract Adequate surgical margins in breast-conserving surgery are an important predictor of local recurrence (LR) rates. The definition of tumor-free margins in National Surgical Adjuvant Breast and Bowel Project (NSABP) trials requires that tumor cells do not touch ink, but subsequent retrospective single-institution studies have suggested that wider margins confer greater protection against LR. Particularly wide margins have been proposed for ductal carcinoma in situ. However, wider margin requirements lead to higher re-excision rates, with attendant economic, psychological, and cosmetic costs, and perhaps increased mastectomy rates. Juxtaposed against these concerns about optimal margin width, a meta-analysis of clinical trials has demonstrated the s...

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Intraoperative assessment of surgical margins during breast conserving surgery of ductal carcinoma in situ by use of radiofrequency spectroscopy

The Breast — Thu, 01 Sep 2011 04:00:00 +0100

We present results for 22 patients, from those enrolled in our institution. The device was used as an adjunctive tool to current practice. Based on permanent histology reporting, the rate of successful procedures was 86%. The improvement in intraoperative assessment with device use was associated with a reduction in re-excision rates, from 38.8 to 18%. (Source: The Breast)

Intraoperative assessment of surgical margins during breast conserving surgery of ductal carcinoma in situ by use of radiofrequency spectroscopy.

Breast — Tue, 30 Aug 2011 04:00:00 +0100

Disease-free probability after the first primary ductal carcinoma in situ of the breast: a comparison between African-American and White-American women

Breast Cancer Research and Treatment — Fri, 26 Aug 2011 16:16:26 +0100

Abstract Compelling evidence about the differences in the biology and behavior of invasive breast cancer between African-American (AA) and White-American (WA) women motivate inquiry into comparing the clinicopathology of non-invasive breast cancer (ductal carcinoma in situ, DCIS). AA and WA women diagnosed with their first primary DCIS between 1990 and 1999 were identified from the institutional tumor registry. Data on method of presentation, treatment, and patient characteristics were retrieved from electronic medical records. Patients were followed up through the medical records until the diagnosis of a subsequent cancer or the last day of contact with the institution. A total of 100 (29.6%) AAs and 236 (70.4%) WAs with the mean age of 60 (SD ± 13) and 57 (SD&n...

Predictive factors for BRCA1/BRCA2 mutations in women with ductal carcinoma in situ

Cancer — Wed, 24 Aug 2011 23:00:00 +0100

CONCLUSIONS:Women who had DCIS and a family history of OC or who had BRCAPRO scores ≥10% had a high rate of BRCA positivity regardless of age at diagnosis. These findings suggest that high‐risk patients with DCIS are appropriate candidates for genetic testing for BRCA mutations in the presence of predictive factors even if they do not have invasive breast cancer. Cancer 2011;. © 2011 American Cancer Society. (Source: Cancer)

Disparities in Reconstruction Rates after Mastectomy for Ductal Carcinoma in Situ (DCIS): Patterns of Care and Factors Associated with the Use of Breast Reconstruction for DCIS Compared with Invasive Cancer

Annals of Surgical Oncology — Wed, 24 Aug 2011 07:20:13 +0100

Conclusions Postmastectomy rates for DCIS were twice those for invasive cancer mostly because stage was not a limiting factor. However, significant factors remain that limit the use of reconstruction in this breast cancer population: age, race/ethnicity, type of hospital, and type of insurance. Content Type Journal ArticleCategory American Society of Breast SurgeonsPages 1-10DOI 10.1245/s10434-011-2010-yAuthors Laura Kruper, General and Oncologic Surgery, City of Hope, USAXinxin Xu, Population Sciences, City of Hope, USAKatherine Henderson, Population Sciences, City of Hope, USALeslie Bernstein, Population Sciences, City of Hope, USA Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)

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US-Guided Vacuum-Assisted Percutaneous Excision for Management of Benign Papilloma Without Atypia Diagnosed at US-Guided 14-Gauge Core Needle Biopsy

Annals of Surgical Oncology — Wed, 24 Aug 2011 07:20:13 +0100

Conclusions For the postbiopsy management of benign papilloma without atypia after US-guided CNB, US-guided VAE was accurate and could be alternative to surgery. In cases of diagnosis of atypical lesion at VAE, however, surgery should be performed for a definitive diagnosis. Content Type Journal ArticleCategory Breast OncologyPages 1-7DOI 10.1245/s10434-011-2033-4Authors Ji Hyun Youk, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South KoreaMin Jung Kim, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South KoreaEun Ju Son, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Se...

Lobular In-Situ Neoplasia on Breast Core Needle Biopsy: Imaging Indication and Pathologic Extent Can Identify Which Patients Require Excisional Biopsy

Annals of Surgical Oncology — Tue, 23 Aug 2011 05:56:10 +0100

Conclusions Women with a CNB diagnosis of LN for calcifications found on routine, normal-risk mammographic screening have a negligible risk of upgrade and may not require excisional biopsy. However, excisional biopsy should be offered to women undergoing imaging for other indications or with >4 foci of LN on CNB. Content Type Journal ArticleCategory Breast OncologyPages 1-8DOI 10.1245/s10434-011-2034-3Authors Mara H. Rendi, Department of Anatomic Pathology, University of Washington Medical Center, Seattle, WA, USASuzanne M. Dintzis, Department of Anatomic Pathology, University of Washington Medical Center, Seattle, WA, USAConstance D. Lehman, Department of Radiology, University of Washington Medical Center, Seattle, WA, USAKristine E. Calhoun, Department of Surge...

Preoperative Predictors of Nipple–Areola Complex Involvement for Patients Undergoing Mastectomy for Breast Cancer

Annals of Surgical Oncology — Tue, 23 Aug 2011 05:55:59 +0100

Conclusions Clinical and imaging abnormalities at the NAC are the only independent preoperative predictors of NAC pathology, and the absence of these factors conveys a low probability of NAC involvement. Content Type Journal ArticleCategory American Society of Breast SurgeonsPages 1-6DOI 10.1245/s10434-011-2008-5Authors Julie A. Y. Billar, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USAAmylou C. Dueck, Department of Biostatistics, Mayo Clinic in Arizona, Phoenix, AZ, USARichard J. Gray, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USANabil Wasif, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USABarbara A. Pockaj, Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA Journal ...

A Look into the Ductoscope: Its Role in Pathologic Nipple Discharge

Annals of Surgical Oncology — Tue, 23 Aug 2011 05:55:54 +0100

Conclusions The majority of patients with pathologic nipple discharge have benign nonproliferative findings or benign papillomas. Although atypia and malignancy were diagnosed in only 7% of patients who underwent ductoscopy for pathologic nipple discharge, there were no routine imaging findings indicative of these diagnoses preoperatively. Content Type Journal ArticleCategory American Society of Breast SurgeonsPages 1-5DOI 10.1245/s10434-011-1962-2Authors C. S. Fisher, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USAJ. A. Margenthaler, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Onc...

Grading ductal carcinoma in situ of the breast using an automated proliferation index.

Annals of Clinical and Laboratory Science — Fri, 19 Aug 2011 23:04:06 +0100

Authors: Stasik CJ, Davis M, Kimler BF, Fan F, Damjanov I, Thomas P, Tawfik OW Abstract Tumor grade, size and margin status are the most significant factors in predicting the behavior of ductal carcinoma in-situ (DCIS). The inclusion of necrosis and nuclear grade in the grading of DCIS has demonstrated a fair but suboptimal agreement between pathologists. The grading of DCIS was studied and compared to the Van Nuys (VN) system, by using our newly proposed unifying "nuclear grade + proliferation index (N+P) grading system for invasive carcinomas. 162 DCIS tumors were studied including 49 VN I, 31 VN II, and 82 VN III cases. The VN and N+P systems were compared with each other and correlated with tumor size, ER, PR, p53, Her-2, EGFR, Bcl-2, p27 and p21 status. The two systems demonst...

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Cancellation of MR Imaging-guided Breast Biopsy Due to Lesion Nonvisualization: Frequency and Follow-Up [Breast Imaging]

Continuous Publishing articles — Wed, 17 Aug 2011 23:00:00 +0100

How should screeners respond to women's distress about unexpected DCIS uncertainties?

Journal of Medical Screening — Wed, 17 Aug 2011 23:00:00 +0100

(Source: Journal of Medical Screening)

Women's distress about unexpected DCIS uncertainties and information provision (response to Pryke et al.)

Journal of Medical Screening — Wed, 17 Aug 2011 23:00:00 +0100

(Source: Journal of Medical Screening)

A Comparative Analysis of Biomarker Expression and Molecular Subtypes of Pure Ductal Carcinoma In Situ and Invasive Breast Carcinoma by Image Analysis: Relationship of the Subtypes with Histologic Grade, Ki67, p53 Overexpression, and DNA Ploidy

Advances in Urology — Wed, 17 Aug 2011 14:18:08 +0100

There is a paucity of data regarding molecular subtypes of pure ductal carcinoma in situ (pDCIS). We evaluated the expression of ER, PR, HER2, Ki67, and p53 and DNA ploidy in 118 pDCIS and 100 invasive breast carcinomas (IBCAs) by routine IHC and classified them according to molecular subtypes. Quantification of biomarkers and DNA ploidy was performed by image analysis. Expression of ER, PR, and high ki67 was more frequent in pDCIS compared to IBCA. High-grade tumors had lower ER and PR expression, high Ki67, overexpression of HER2 and p53, and DNA aneuploidy. Luminal A and HER2 subtypes were more common in pDCIS, and triple negative was more prevalent in IBCA. In both groups, HER2 and triple negative subtypes were characterized by high ki67, overexpression of p53, and DNA aneuploidy compa...

Nipple-Sparing Mastectomy for Breast Cancer and Risk-Reducing Surgery: The Memorial Sloan-Kettering Cancer Center Experience

Annals of Surgical Oncology — Wed, 17 Aug 2011 05:53:24 +0100

Conclusions The trends demonstrate the increasing acceptance of NSM as a prophylactic procedure as well as for therapeutic purposes. Although NSM is not standard, our experience supports the selective use of NSM in both prophylactic and malignant settings. Content Type Journal ArticleCategory American Society of Breast SurgeonsPages 1-6DOI 10.1245/s10434-011-1974-yAuthors Paulo de Alcantara Filho, Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USADeborah Capko, Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USAJohn Mitchel Barry, Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USAMonica Morrow, Breast Service, Department of Surgery,...

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Correlation of Ductal Lavage Cytology with Ductoscopy-Directed Duct Excision Histology in Women at High Risk for Developing Breast Cancer: A Prospective, Single-Institution Trial

Annals of Surgical Oncology — Wed, 17 Aug 2011 05:53:23 +0100

Conclusions Although 20% of high-risk women with ductal lavage atypia have AH or malignancy on subsequent excision, the majority do not. Atypia identified by ductal lavage is not associated with a higher risk of developing subsequent breast cancer, even in this high-risk population. Content Type Journal ArticleCategory American Society of Breast SurgeonsPages 1-6DOI 10.1245/s10434-011-1963-1Authors Amy E. Cyr, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USAJulie A. Margenthaler, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USAJill Conway, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USAAntonella L. Rastelli, Department of Medicine, Washington University School o...

A Murine Mammary Tumor Virus env-Like Exogenous Sequence Is Strictly Related to Progression of Human Sporadic Breast Carcinoma.

The American Journal of Pathology — Tue, 16 Aug 2011 23:00:00 +0100

Authors: Mazzanti CM, Hamad MA, Fanelli G, Scatena C, Zammarchi F, Zavaglia K, Lessi F, Pistello M, Naccarato AG, Bevilacqua G Abstract A viral etiology of human breast cancer (HBC) has been postulated for decades since the identification of murine mammary tumor virus (MMTV). The detection of MMTV env-like exogenous sequences (MMTVels) in 30% to 40% of invasive HBCs increased attention to this hypothesis. Looking for MMTVels during cancer progression may contribute to a better understanding of their role in HBC. Herein, we analyzed HBC preinvasive lesions for the presence of MMTVels. Samples were obtained by laser microdissection of FFPE tissues: 20 usual-type ductal hyperplasias, 22 atypical ductal hyperplasias (AHs), 49 ductal carcinomas in situ (DCISs), 20 infiltrating ductal ca...

Can We Know What to Do When DCIS Is Diagnosed?

Cancer Network — Tue, 16 Aug 2011 17:00:02 +0100

Despite the 20-year-old dogma that all patients treated with breast conservation should receive postoperative radiation, a subset of patients who can be successfully treated by excision alone has been identified. (Source: Cancer Network)

Outcome of long term active surveillance for estrogen receptor-positive ductal carcinoma in situ

The Breast — Tue, 16 Aug 2011 04:00:00 +0100

Conclusion: Long-term active surveillance for DCIS is feasible in a well-informed patient population, but is associated with risk of invasive cancer at surgical excision. (Source: The Breast)

Outcome of long term active surveillance for estrogen receptor-positive ductal carcinoma in situ.

Breast — Fri, 12 Aug 2011 23:00:00 +0100

CONCLUSION: Long-term active surveillance for DCIS is feasible in a well-informed patient population, but is associated with risk of invasive cancer at surgical excision. PMID: 21843942 [PubMed - as supplied by publisher] (Source: Breast)

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Comparison of Increased Aromatase versus ER{alpha} in the Generation of Mammary Hyperplasia and Cancer

Cancer Research — Wed, 10 Aug 2011 23:00:00 +0100

Factors associated with increased estrogen synthesis increase breast cancer risk. Increased aromatase and estrogen receptor α (ERα) in both normal epithelium and ductal carcinoma in situ lesions are found in conjunction with breast cancer, leading to the idea that altered estrogen signaling pathways predispose the mammary gland to cancer development. Here, we developed a transgenic mouse that conditionally expresses aromatase in the mammary gland, and used it along with a deregulated ERα expression model to investigate the molecular pathways involved in the development of mammary gland preneoplasia and carcinoma. Both increased ERα and aromatase expression led to the development of preneoplasia, but increased preneoplasia, in addition to carcinoma, was found in aromatase overexpressing...

Nomogram to predict ipsilateral breast relapse based on pathology review from the EORTC 22881-10882 boost versus no boost trial

Radiotherapy and Oncology — Sun, 07 Aug 2011 23:00:00 +0100

Abstract: Background and purpose: The EORTC 22881-10882 trial showed that for patients treated with breast conserving therapy (BCT), a 16Gy boost dose significantly improved local control, but increased the risk of breast fibrosis. A model to estimate the risk of ipsilateral breast relapse (IBR) already exists, but now a model has been developed which takes boost treatment into account and is based on centrally reviewed pathology.Materials and methods: A Cox model was developed based on central pathology review data and clinical data of 1603 patients from the EORTC 22881-10882 trial with a median follow-up of 11.5years. From a predefined set of variables, predictors with a maximal effect on 10-year IBR rate >4% were retained in the model. Bootstrap re-sampling was used to assess model cali...

Postpartum mammary gland involution drives progression of ductal carcinoma in situ through collagen and COX-2

Nature Medicine — Sun, 07 Aug 2011 04:00:00 +0100

Authors: Traci R Lyons, Jenean O'Brien, Virginia F Borges, Matthew W Conklin, Patricia J Keely, Kevin W Eliceiri, Andriy Marusyk, Aik-Choon Tan & Pepper Schedin (Source: Nature Medicine)

Excised and irradiated volumes in relation to the tumor size in breast-conserving therapy

Breast Cancer Research and Treatment — Sat, 06 Aug 2011 06:00:14 +0100

In conclusion, both the excised and the irradiated POC volumes did not show a clinically relevant association with the mTD in women with early-stage breast cancer treated with breast-conserving therapy. Future studies should focus on improvement of surgical localization, development of image-guided, minimally invasive operation techniques, and more accurate image-guided target volume delineation in radiotherapy. Content Type Journal ArticlePages 1-9DOI 10.1007/s10549-011-1696-7Authors M. D. den Hartogh, Department of Radiation Oncology, Utrecht University Medical Center, PO Box 85500, 3508 GA Utrecht, The NetherlandsB. van Asselen, Department of Radiation Oncology, Utrecht University Medical Center, PO Box 85500, 3508 GA Utrecht, The NetherlandsE. M. Monninkhof, Julius Center for...

Nomogram to predict ipsilateral breast relapse based on pathology review from the EORTC 22881-10882 boost versus no boost trial.

Thu, 04 Aug 2011 23:00:00 +0100

CONCLUSIONS: The nomogram for predicting IBR 10years after BCT includes seven factors, with young age, presence of DCIS and boost treatment as the most dominant factors. The nomogram estimates IBR and confirms the importance of a boost dose. Combined with a model to predict fibrosis published previously, the nomogram presented here may assist in decision making for individual patients. PMID: 21821304 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

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Effectiveness of Computer-Aided Detection in Community Mammography Practice

JNCI — Mon, 01 Aug 2011 23:00:00 +0100

Conclusion CAD use during film-screen screening mammography in the United States is associated with decreased specificity but not with improvement in the detection rate or prognostic characteristics of invasive breast cancer. (Source: JNCI)

Tailored strategies for DCIS management.

Oncology (Williston Park, N.Y.) — Mon, 01 Aug 2011 04:00:00 +0100

Authors: Javid SH, Anderson BO PMID: 21936453 [PubMed - in process] (Source: Oncology (Williston Park, N.Y.))

Management of DCIS--a work in progress.

Oncology (Williston Park, N.Y.) — Mon, 01 Aug 2011 04:00:00 +0100

Authors: Kulkarni S PMID: 21936452 [PubMed - in process] (Source: Oncology (Williston Park, N.Y.))

Can we know what to do when DCIS is diagnosed?

Oncology (Williston Park, N.Y.) — Mon, 01 Aug 2011 04:00:00 +0100

Authors: Sanders ME, Simpson JF Abstract Utilizing routine histopathologic parameters obtained from appropriately handled lumpectomy and mastectomy specimens, a rational therapeutic plan based on epidemiologic and outcome-based data can be devised for any patient diagnosed with ductal carcinoma in situ (DCIS). In order to make a sound decision when weighing the current treatment options for DCIS--which include excision alone, excision plus radiation, and mastectomy--the following are mandatory: 1) assurance of an accurate diagnosis, 2) assessment of DCIS size and grade, and 3) careful margin evaluation. Accurate grading of DCIS is critical, since high nuclear grade and the presence of necrosis are highly predictive of the inability to achieve adequate margins, of local recurrence, ...

The changing field of locoregional treatment for breast cancer.

Oncology (Williston Park, N.Y.) — Mon, 01 Aug 2011 04:00:00 +0100

Authors: Rizzo M, Wood WC Abstract The change to less-morbid local therapy for operable breast cancer continues. Systemic induction therapy, whether hormonal therapy or chemotherapy, increases the eligibility for breast-conserving surgery. Sentinel lymph node biopsy (SLNB) has greatly reduced the requirement for axillary dissection, and recent data show that, in addition, whole-breast irradiation can obviate the need for dissection in most patients with clinically node-negative, SLN-positive disease. Although resection margins must be negative for best results, there is no clear evidence that margins exceeding "no ink on tumor" for invasive cancer, or 2 mm for ductal carcinoma in situ, are significantly better. The role of radiation has been clarified, with a clear survival advanta...

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Expression of class 3 semaphorins and their receptors in human breast neoplasia

Histopathology — Sun, 31 Jul 2011 23:00:00 +0100

Conclusion: These data suggest that a decrease in class 3 semaphorin and their plexin receptors have some relationship with disease progression in ductal breast carcinoma. (Source: Histopathology)

Higher mammographic density associated with more aggressive tumors, DCIS

HemOncToday.com — Wed, 27 Jul 2011 16:12:00 +0100

Kerlikowske K. J Natl Cancer Inst. 2011;doi:10.1093/jnci/djr263 Yaghjyan L. J Natl Cancer Inst. 2011;doi:10.1093/jnci/djr225. (Source: HemOncToday.com)

The shifting nature of women’s experiences and perceptions of ductal carcinoma in situ

Journal of Advanced Nursing — Wed, 27 Jul 2011 04:17:29 +0100

Conclusion. This study represents one of the few longitudinal qualitative studies with newly diagnosed patients, capturing women’s initial and shifting experiences and perceptions of the condition. The issues identified need to be recognized in clinical practice and supported appropriately. (Source: Journal of Advanced Nursing)

Clinicopathologic correlation of cancer stem cell markers CD44, CD24, VEGF and HIF-1α in ductal carcinoma in situ and invasive ductal carcinoma of breast: An immunohistochemistry-based pilot study.

Pathology, Research and Practice — Tue, 26 Jul 2011 23:00:00 +0100

Authors: Wang Z, Shi Q, Wang Z, Gu Y, Shen Y, Sun M, Deng M, Zhang H, Fang J, Zhang S, Xie F CD24(-/low)CD44(+) cells have been identified as putative cancer stem cells (CSCs) in breast cancer. However, the expression of these markers, as well as their association with clinical parameters or tumor microenvironment of breast cancer, remains largely unknown. In the present study, we examined the expression of CD44, CD24, VEGF, and HIF-1α in human breast tumor tissues and assessed their clinicopathological correlations. We investigated tissue samples, including 117 cases of invasive ductal carcinoma (IDCa), 14 cases of ductal carcinoma in situ (DCIS), and 15 cases of intraductal hyperplasia (IDH) from breast tissues. The expression of CD44, CD24, HIF-1α, and VEGF was evaluated using imm...

G-protein coupled receptor-associated sorting protein 1 (GASP-1), a potential biomarker in breast cancer.

Experimental and Molecular Pathology — Fri, 22 Jul 2011 23:00:00 +0100

Authors: Tuszynski GP, Rothman VL, Zheng X, Gutu M, Zhang X, Chang F An innovative "2-D high performance liquid electrophoresis" (2-D HPLE) technology was used to identify serum biomarkers associated with the early stage of breast cancer in addition to other more advanced stages. 2-D HPLE is a newly developed electrophoretic technology that separates 100s of serum albumin complexes on a polyvinyl membrane based on their surface charges. Association of cancer proteins or their fragments (biomarkers) with pre-existing albumin complexes in the blood of cancer patients results in altered mobility on the membrane. Using 2-D HPLE we identified that a specific fragment of G-protein coupled receptor-associated sorting protein 1 (GASP-1) was present in the sera of patients with early stage dise...

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Radiology: Biopsy commonly understages DCIS

Health Imaging News — Fri, 22 Jul 2011 10:36:12 +0100

As many as one-fourth of cases of ductal carcinoma in situ (DCIS) diagnosed using core-needle biopsy are in fact understaged invasive breast cancers, according to a study published in the July issue of Radiology. (Source: Health Imaging News)

Radiology: Biopsy commonly understages invasive breast cancer

Health Imaging News — Fri, 22 Jul 2011 10:36:12 +0100

Ductal carcinoma in situ of the male breast presenting as adolescent unilateral gynaecomastia

Journal of Plastic, Reconstructive and Aesthetic Surgery — Fri, 22 Jul 2011 04:00:00 +0100

In conclusion this case describes a rare pre-malignant condition of the male breast. Complete histology of such a lump is the only conclusive investigation necessary and the limitations put upon the surgeon by the “rationing” of such treatment must be overcome on clinical grounds. (Source: Journal of Plastic, Reconstructive and Aesthetic Surgery)

The two faces of autophagy and the pathological underestimation of DCIS

Nature Reviews Cancer — Thu, 21 Jul 2011 23:00:00 +0100

Authors: Ke-Da Yu & Zhi-Ming Shao We read with great interest the Opinion article (What is the malignant nature of human ductal carcinoma in situ?Nature Rev. Cancer11, 68–75 (2011)) by Espina and Liotta, in which the authors present the (Source: Nature Reviews Cancer)

A response to the two faces of autophagy in DCIS

Nature Reviews Cancer — Thu, 21 Jul 2011 23:00:00 +0100

Authors: Virginia Espina & Lance A. Liotta Regarding our recent Opinion article (What is the malignant nature of human ductal carcinoma in situ?Nature Rev. Cancer11, 68–75 (2011)) we thank Drs Yu and Shao for their correspondence (The two faces (Source: Nature Reviews Cancer)

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Ductal Carcinoma In Situ: Detection, Diagnosis, and Characterization with Magnetic Resonance Imaging

Seminars in Ultrasound CT and MRI — Thu, 21 Jul 2011 19:26:56 +0100

This article reviews how clinical magnetic resonance imaging methods are being implemented for the detection, diagnosis and characterization of DCIS. Research strategies that are being pursued to help realize the full potential for magnetic resonance imaging to improve the outcomes of patients diagnosed with DCIS are discussed. (Source: Seminars in Ultrasound CT and MRI)

Spectrum of Diseases Presenting as Architectural Distortion on Mammography: Multimodality Radiologic Imaging with Pathologic Correlation

Seminars in Ultrasound CT and MRI — Thu, 21 Jul 2011 19:26:56 +0100

Architectural distortion is the third most-common appearance of breast cancer and often is a subtle finding on mammography. In this article, we review a variety of breast diseases that may present as architectural distortion on mammography; review the utility of correlative imaging, such as ultrasound and magnetic resonance; and review appropriate management for these diagnoses. Primary causes include breast cancer, ductal carcinoma in situ, radial scar, complex sclerosing lesion, and fat necrosis. Secondary etiologies include previous breast surgery, trauma, and infection. Familiarity with imaging findings presenting as distortion on multimodality imaging will optimize detection and management of this subtle-yet-significant finding. (Source: Seminars in Ultrasound CT and MRI)

Apparent Diffusion Coefficient as an MR Imaging Biomarker of Low-Risk Ductal Carcinoma in Situ: A Pilot Study [Breast Imaging]

Radiology — Wed, 20 Jul 2011 23:00:00 +0100

Conclusion: These preliminary results suggest that quantitative diffusion-weighted MR imaging could be used to identify patients with low-grade DCIS with very high specificity. If the results of this study are confirmed, this approach could potentially spare those patients from invasive approaches such as mastectomy or axillary lymph node excision. © RSNA, 2011 (Source: Radiology)

Study of Estrogen Receptor and Progesterone Receptor Expression in Breast Ductal Carcinoma In Situ by Immunohistochemical Staining in ER/PgR-Negative Invasive Breast Cancer

Advances in Pharmacological Sciences — Wed, 20 Jul 2011 17:00:37 +0100

Conclusions. In our study of ER/PgR-negative invasive breast cancer we found that in 8% of cases noncontiguous ER/PR-positive DCIS was present. In light of this finding, it may be important for pathologists to evaluate the ER/PgR status of DCIS occurring in the presence of ER/PgR-negative invasive cancer, as this subgroup could be considered for chemoprevention. (Source: Advances in Pharmacological Sciences)

Indication for relumpectomy—a useful scoring system in cases of invasive breast cancer

Journal of Surgical Oncology — Tue, 19 Jul 2011 23:00:00 +0100

ConclusionsFor patients with surgical margins <2 mm and a score of <4, the probability of finding a residual invasive tumor is 0%, while the probability of finding a microfocus of <2 mm of invasive carcinoma is 3.2% and of finding residual DCIS is up to 10%. J. Surg. Oncol. © 2011 Wiley‐Liss, Inc. (Source: Journal of Surgical Oncology)

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Elevated NRD1 metalloprotease expression plays a role in breast cancer growth and proliferation

Genes, Chromosomes and Cancer — Tue, 19 Jul 2011 15:44:13 +0100

AbstractUnderstanding the molecular etiology of cancer and increasing the number of drugs and their targets are critical to cancer management. In our attempt to unravel novel breast‐cancer associated proteins, we previously conducted protein expression profiling of the MCF10AT model, which comprises a series of isogenic cell lines that mimic different stages of breast cancer progression. NRD1 expression was found to increase during breast cancer progression. Here, we attempted to confirm the relevance of NRD1 in clinical breast cancer and understand the functional role and mechanism of NRD1 in breast cancer cells. Immunohistochemistry data show that NRD1 expression was elevated in ductal carcinoma in situ and invasive ductal carcinomas compared with normal tissues in 30% of the 26 matche...

Study of Estrogen Receptor and Progesterone Receptor Expression in Breast Ductal Carcinoma In Situ by Immunohistochemical Staining in ER/PgR-Negative Invasive Breast Cancer

Anesthesiology Research and Practice — Tue, 19 Jul 2011 14:47:07 +0100

A Single-Institution Review of Accelerated Partial Breast Irradiation in Patients Considered “Cautionary” by the American Society for Radiation Oncology

Annals of Surgical Oncology — Tue, 19 Jul 2011 05:50:22 +0100

Conclusions Patients considered “cautionary” for APBI based on ASTRO guidelines had low rates of IBTR. ER-negative patients trended toward a higher IBTR rate with APBI compared with ER-positive patients. Longer follow-up is needed to establish the safety of APBI in “cautionary” patients. Content Type Journal ArticlePages 1-7DOI 10.1245/s10434-011-1941-7Authors Tari S. Stull, Department of Surgery, The Bryn Mawr Hospital, Bryn Mawr, PA, USAM. Catherine Goodwin, Department of Surgery, The Bryn Mawr Hospital, Bryn Mawr, PA, USAEdward J. Gracely, School of Public Health, Drexel University College of Medicine & Drexel University, Philadelphia, PA, USAMichael R. Chernick, Lankenau Institute of Medical Research, Lankenau Medical Center, Wynnewood, PA, USARichard J....

Understanding a ductal carcinoma in situ diagnosis: patient views and surgeon descriptions

European Journal of Cancer Care — Mon, 18 Jul 2011 23:00:00 +0100

DAVEY C., WHITE V., WARNE C., KITCHEN P., VILLANUEVA E. & ERBAS B. (2011) European Journal of Cancer Care. Understanding a ductal carcinoma in situ diagnosis: patient's views and surgeon descriptionsFollowing the release of the national clinical treatment recommendations for ductal carcinoma in situ (DCIS), consumers' and surgeons' characterisation of this disease was assessed. Telephone interviews were conducted with 231 women diagnosed with DCIS, in Victoria, Australia in 2006/2007 and 63 treating surgeons completed a mailed survey. The main outcome measures were: women's diagnostic experience, women's and surgeons' description of DCIS, women's understanding of DCIS, confusion and worry about the disease and risk perceptions. While the majority of women had not heard of DCIS prior to...