Predicting relapse in ductal carcinoma in situ patients: an analysis of biologic markers with long-term follow-up.
BACKGROUND
The incidence of ductal carcinoma in situ (DCIS) of the breast is increasing. Optimal treatment remains controversial and, because of a long natural history, may not be evident for many years. We undertook this study to identify markers of disease recurrence.


METHODS
We studied 131 pure DCIS patients with a 100-month mean follow-up. We performed a complete histologic review, immunohistochemical staining for p53 and vascular endothelial growth factor expression, and enumerated microvessel density/mm2 using factor VIII-Ab. Statistical analysis was performed by using an SAS software package (Cary, NC).


RESULTS
Eleven patients (8%) developed ipsilateral recurrence at a mean of 55 months (11-137 months) after initial treatment. Three were DCIS, and 8 were invasive cancer. Recurrence was significantly predicted by p53 overexpression (in 55% of tumors that recurred versus 22% of those that did not, P = .02) but not other factors.


CONCLUSIONS
These data suggest that biologic factors may have an important role in predicting recurrence in DCIS patients.
Hieken
Tina J
TJ
Department of Surgery, Rush North Shore Medical Center, 9669 North Kenton Avenue, Suite 204, Skokie, IL 60076, USA. thieken@rush.edu
Cheregi
John
J
Farolan
Miguel
M
Kim
Joan
J
Velasco
Josè M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000737:chemistry / Q000378:metabolism* / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000737:chemistry / Q000378:metabolism* / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D013997:Time Factors; D016159:Tumor Suppressor Protein p53 / Q000032:analysis / Q000096:biosynthesis*; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis / Q000096:biosynthesis*