title: Stromal architecture and periductal decorin are potential prognostic markers for ipsilateral locoregional recurrence in ductal carcinoma in situ of the breast.
abstract: OBJECTIVE
  The incidence of ductal carcinoma in situ (DCIS) has increased since the introduction of screening mammography. Recurrence prediction is still not accurate, and could be improved by identifying additional prognostic markers. Periductal stroma actively participates in early breast cancer progression. Therefore, the aim of this study was to explore the prognostic potential of stromal characteristics in DCIS.
  
  
  RESULTS
  Histopathological features and hormone receptor/HER2 status were analysed in a first cohort of 65 cases of DCIS with a median follow-up of 112 months. Cox regression analysis revealed that myxoid stromal architecture was significantly associated with increased ipsilateral locoregional recurrence (P = 0.015). Next, we performed immunohistochemical screening of nine stromal proteins in a second cohort of 82 DCIS cases, and correlated their expression with stromal architecture. Because reduced stromal decorin expression correlated most strongly with myxoid stroma (P < 0.001), it was selected for further analysis in the first cohort. Patients with reduced periductal decorin expression had a higher risk of recurrence (P = 0.008). Furthermore, HER2 overexpression was significantly associated with invasive but not with in situ recurrence (P = 0.007).
  
  
  CONCLUSIONS
  Periductal myxoid stroma and reduced periductal decorin expression seem to be prognostic for overall ipsilateral locoregional recurrence in DCIS, whereas HER2 expression might be a more specific biomarker for invasive recurrence.
authors.affiliation: Department of Pathology, Ghent University and Ghent University Hospital, Ghent, Belgium.
authors.forename: Mieke
authors.initials: M
authors.lastname: Van Bockstal
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lambein
authors.forename: Olivier
authors.initials: O
authors.lastname: Gevaert
authors.forename: Olivier
authors.initials: O
authors.lastname: De Wever
authors.forename: Marleen
authors.initials: M
authors.lastname: Praet
authors.forename: Veronique
authors.initials: V
authors.lastname: Cocquyt
authors.forename: Rudy
authors.initials: R
authors.lastname: Van den Broecke
authors.forename: Geert
authors.initials: G
authors.lastname: Braems
authors.forename: Hannelore
authors.initials: H
authors.lastname: Denys
authors.forename: Louis
authors.initials: L
authors.lastname: Libbrecht
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000378:metabolism / Q000473:pathology*; D058575:Decorin / Q000032:analysis / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology; D059016:Tumor Microenvironment / Q000502:physiology
chemical_list: D014408:Biomarkers, Tumor; C546878:DCN protein, human; D058575:Decorin
keywords: DCIS; breast; decorin; ductal carcinoma in situ; invasive recurrence; ipsilateral locoregional recurrence; myxoid stroma; prognostic biomarkers; protein expression