Pathological and Biological Differences Between Screen-Detected and Interval Ductal Carcinoma in situ of the Breast
Open Access
- 24 April 2007
- journal article
- research article
- Published by Springer Science and Business Media LLC in Annals of Surgical Oncology
- Vol. 14 (7), 2097-2104
- https://doi.org/10.1245/s10434-007-9395-7
Abstract
The incidence of ductal carcinoma in situ (DCIS) has risen dramatically with the introduction of screening mammography. The aim was to evaluate differences in pathological and biological characteristics between patients with screen-detected and interval DCIS. From January 1992 to December 2001, 128 consecutive patients had been treated for pure DCIS at our institute. From these, 102 had been attending the Dutch breast cancer screening program. Sufficient paraffin-embedded tissue was available in 74 out of the 102 cases to evaluate biological marker expression (Her2/neu, ER, PR, p53 and cyclin D1) on tissue microarrays (TMA group). Differences in clinicopathological characteristics and marker expression between screen-detected and interval patients were evaluated. Screen-detected DCIS was classified as DCIS detected by screening mammography, when the two-year earlier examination failed to reveal an abnormality. Interval patients were classified as patients with DCIS detected within the two-year interval between two subsequent screening rounds. Screen-detected DCIS was related with linear branching and coarse granular microcalcifications on mammography (p < .001) and with high-grade DCIS according to the Van Nuys classification (p = .025). In univariate analysis, screen-detected DCIS was related with Her2/neu overexpression (odds ratio [OR] = 6.5; 95%CI 1.3-31.0; p = .020), and interval DCIS was associated with low-grade (Van Nuys, OR = 7.3; 95% CI 1.6-33.3; p = .010) and PR positivity (OR = 0.3; 95%CI 0.1-1.0; p = .042). The multivariate analysis displayed an independent relation of Her2/neu overexpression with screen-detected DCIS (OR = 12.8; 95%CI 1.6-104.0; p = .018). These findings suggest that screen-detected DCIS is biologically more aggressive than interval DCIS and should not be regarded as overdiagnosis.Keywords
This publication has 34 references indexed in Scilit:
- Changing patterns in diagnosis and treatment of ductal carcinoma in situ of the breastEuropean Journal of Surgical Oncology, 2005
- Molecular markers and therapeutic targets in ductal carcinoma in situMicroscopy Research and Technique, 2002
- How Significant is Detection of Ductal Carcinoma In Situ in a Breast Screening Programme?Clinical Radiology, 2002
- Histopathological and Cell Biological Factors of Ductal Carcinoma in Situ Before and After the Introduction of Mammographic ScreeningActa Oncologica, 2001
- Radiotherapy in breast-conserving treatment for ductal carcinoma in situ: first results of the EORTC randomised phase III trial 10853The Lancet, 2000
- Differential expression of collagen type IV alpha-chains in the tubulointerstitial compartment in experimental chronic serum sickness nephritisThe Journal of Pathology, 1999
- Tissue microarrays for high-throughput molecular profiling of tumor specimensNature Medicine, 1998
- Using Autopsy Series To Estimate the Disease “Reservoir” for Ductal Carcinoma in Situ of the Breast: How Much More Breast Cancer Can We Find?Annals of Internal Medicine, 1997
- Mammographically detected ductal carcinoma in situ: Are we overdiagnosing breast cancer?Surgery, 1995
- Ductal carcinoma in situ of the breast: correlation between mammographic calcification and tumor subtype.American Journal of Roentgenology, 1992