title: Molecular Markers as Prognostic Factors in DCIS and Small Invasive Breast Cancers.
abstract: Ductal carcinoma in situ (DCIS) accounts for up to half of screen-detected breast cancers and thus constitutes a major public health problem. Despite effective current treatment many patients with DCIS are either over- or undertreated because of the paucity of precise models to predict recurrence or progression. The combination of clinical and molecular factors as already applied for invasive disease may help to build such models also for DCIS. We compared 53 DCIS (36.6 %) and 92 (63.4 %) invasive breast cancer cases and found no significant differences in age, receptor status of ER, PR, and HER2, and the use of radiotherapy. Interestingly, the proportion of disseminated tumor cells (DTC) did also not significantly differ between DCIS and invasive cases (p = 0.57). A negative PR status was associated with the detection of DTCs (p = 0.026). We then compared relationships of clinical parameters and biomarkers with patients' prognosis in 43 DCIS and 40 small invasive tumors ≤ 5 mm (T1a). ER negativity was associated with shorter relapse free survival in the complete cohort (p = 0.004) and showed a trend in both subgroups (p = 0.053 for DCIS and p = 0.046 for T1a, respectively). In conclusion, we found markedly similar properties of both DCIS and small invasive breast cancers with respect to the distribution of several parameters as well as to the prognostic value of biomarkers. DCIS with a luminal phenotype seem to be characterized by a favourable prognosis.
authors.affiliation: Dept. of Gynecology and Obstetrics, Goethe University Frankfurt, Frankfurt.
authors.forename: N
authors.initials: N
authors.lastname: Sänger
authors.affiliation: Zentrum für Pathologie, Zytologie und Molekularpathologie, Neuss.
authors.forename: K
authors.initials: K
authors.lastname: Engels
authors.affiliation: Dept. of Gynecology and Obstetrics, Goethe University Frankfurt, Frankfurt.
authors.forename: A
authors.initials: A
authors.lastname: Graf
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf.
authors.forename: E
authors.initials: E
authors.lastname: Ruckhäberle
authors.affiliation: University Medical Center Hamburg-Eppendorf, Hamburg.
authors.forename: K E
authors.initials: KE
authors.lastname: Effenberger
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf.
authors.forename: T
authors.initials: T
authors.lastname: Fehm
authors.affiliation: Dept. of Gynecology and Obstetrics, Goethe University Frankfurt, Frankfurt.
authors.forename: U
authors.initials: U
authors.lastname: Holtrich
authors.affiliation: Dept. of Gynecology and Obstetrics, Goethe University Frankfurt, Frankfurt.
authors.forename: S
authors.initials: S
authors.lastname: Becker
authors.affiliation: Dept. of Gynecology and Obstetrics, Goethe University Frankfurt, Frankfurt.
authors.forename: T
authors.initials: T
authors.lastname: Karn
keywords: DCIS; ER status; breast cancer; molecular subtypes; prognosis