Systematic Review Links the Prevalence of Intraductal Carcinoma of the Prostate to Prostate Cancer Risk Categories.
Intraductal carcinoma of the prostate (IDC-P) is associated with poor prognosis. While it is often regarded as a rare pathology, the prevalence of IDC-P remains unclear, with variable reports from small and disparate patient populations. To determine how common IDC-P is across the spectrum of prostate cancer, we conducted a systematic review correlating IDC-P prevalence with prostate cancer risk. Electronic searches of the OVID Medline, PubMed, and Scopus literature databases identified 38 patient cohorts in 24 articles, which were divided between four prostate cancer risk categories (low, moderate, high, and recurrent or metastatic disease). This review, which included radical prostatectomy and prostate biopsy specimens from >7000 patients, revealed an unexpectedly high rate of IDC-P. The IDC-P prevalence increased from 2.1% in low-risk patient cohorts to 23.1%, 36.7%, and 56.0% in moderate-risk, high-risk, and metastatic or recurrent disease risk categories, respectively (p<0.0001). IDC-P was also highly prevalent in tumours following androgen deprivation therapy or chemotherapy (60%). Contrary to common perceptions, this study demonstrates a strong association between IDC-P prevalence and aggressive prostate cancer, with a significantly higher frequency in high-risk disease. Greater recognition and systematic reporting of IDC-P may improve patient risk stratification.



Prostate cancer can grow within ducts of the prostate, as well as in prostate tissue. By reviewing all reports describing prostate cancer growing within ducts, we found that it occurs more commonly than many scientists and clinicians appreciate, especially in aggressive prostate cancers. We conclude that there should be more awareness of this pattern of prostate cancer.
Department of Anatomy and Developmental Biology, Biomedicine Discovery Institute, Monash University, Melbourne, Australia; Prostate Cancer Research Program, Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia.
Laura H
LH
Porter
Department of Anatomy and Developmental Biology, Biomedicine Discovery Institute, Monash University, Melbourne, Australia; Prostate Cancer Research Program, Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia.
Mitchell G
MG
Lawrence
School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.
Dragan
D
Ilic
TissuPath, Mount Waverley, Australia.
David
D
Clouston
Department of Urology, Austin Hospital, Melbourne, Australia; Department of Surgery, University of Melbourne, Melbourne, Australia.
Damien M
DM
Bolton
Department of Anatomy and Developmental Biology, Biomedicine Discovery Institute, Monash University, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia.
Mark
M
Frydenberg
Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Australian Prostate Cancer Research Centre, Epworth Healthcare, Richmond, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. Electronic address: declan.murphy@petermac.org.
Declan G
DG
Murphy
Department of Anatomy and Developmental Biology, Biomedicine Discovery Institute, Monash University, Melbourne, Australia; Eastern Health Clinical School, Monash University, Melbourne, Australia.
Carmel
C
Pezaro
Department of Anatomy and Developmental Biology, Biomedicine Discovery Institute, Monash University, Melbourne, Australia; Prostate Cancer Research Program, Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia.
Gail P
GP
Risbridger
Department of Anatomy and Developmental Biology, Biomedicine Discovery Institute, Monash University, Melbourne, Australia; Prostate Cancer Research Program, Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, Australia. Electronic address: renea.taylor@monash.edu.
Renea A
RA
Taylor
D002277:Carcinoma / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D049109:Cell Proliferation; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors
BRCA2 germline mutation; Intraductal; Pathology; Prostate cancer; Review; Risk stratification