Recurrence in Ductal Carcinoma In Situ (DCIS): A Clinico-Pathological Study
Frederique Penault-Llorca, Lucie Tixier, Anne Cayre, Fabrice Kwiatkowski, Guillaume Lebouedec, Nina Radosevic-Robin, Catherine Abrial, Florence Mishellany, Marie-Melanie Dauplat. Centre Jean Perrin and EA 4677 ERTICa University of Auvergne, Clermont-Ferrand, France; Centre Jean Perrin, Clermont-Ferrand, France
Background: Ductal carcinoma in situ account for approximately 15-20 % of all newly diagnosed breast cancers corresponding to 7000-8000 new cases every year in France. Currently, therapeutic decision is taken according to different factors: size of the lesion, surgical possibilities, and the patient's will. But, DCIS appears to be as complex and heterogeneous disease at the biological and morphological level as invasive carcinoma. Our aim was to define clinical and biological risk factors for recurrence in order to provide an optimized and personalized treatment.
Design: Retrospective study of 87 patients (mean age 53 yrs) treated by conservative treatment (surgery and radiation therapy) for pure DCIS. Clinical and immunohistochemical data were studied. For each lesion, we analysed several markers (ER, RP, HER-2, EGFR, CK 5/6, P-Cadherin, p53, Ki67, RA, p63). Eight local recurrences (LR) occurred (9.2 %): 5 in situ (62 %) and 3 invasive. Furthermore, 6 contralateral events were observed.
Results: Mean size 1,4cm, grade 2: 55%, ER+: 88,5% PR+: 41,8%,HER2+: 17%. Risk of recurrence was significantly associated with tumour size > 5 mm (p= 0.032 for LR), necrosis (p=0.048 for LR and p=0.03 for any new events (ANE)), Ki67>5% (p=0.015 for ANE), dense inflammatory infiltrate p=0,025, low p-cadherin membrane staining (p=0,016), decrease in p63 staining (p=0,049). On multivariate analysis for tumors>0.5cm, low membrane p-cadherin and Ki67>5% were the only significant markers, associated to a risk of relapse of 7.7 and 6.5 respectively.
Conclusions: Ki67 and P-cadherin evaluations in DCIS should be tested in larger series to confirm their potential use in the evaluation of DCIS aggressiveness. More data will be presented at the meeting (molecular signature for DCIS and comparison with a group of micro-invasive carcinoma).
Monday, March 4, 2013 1:00 PM
Poster Session II # 59, Monday Afternoon