Biologic behavior and long-term outcomes of breast ductal carcinoma in situ with microinvasion.

Abstract

BACKGROUND:

Ductal carcinoma in situ with microinvasion (DCIS-Mi) generally has favorable prognosis, but the long-term outcomes of DCIS-Mi and the biologic evolution from ductal carcinoma in situ (DCIS), DCIS-Mi, to DCIS with T1a breast cancer (DCIS-T1a) has not been specified. The aim of our study was to explore the biological and prognostic features of DCIS-Mi, compared with pure DCIS and DCIS-T1a.

RESULTS:

After a median follow-up of 31 months, the 3-year estimated disease free survival(DFS) rate of DCIS-Mi patients was significantly lower than that of pure DCIS patients (89.5% vs 97.1%, P=0.009). Patients with DCIS-Mi or DCIS-T1a tumors had comparable 3-year estimated DFS rates (89.5% vs 94.3%, P=0.13). No significant difference in overall survival (OS) was found among different groups (99.6%, 100% and 99.1% for DCIS, DCIS-Mi and DCIS-T1a, P=0.797). In chemotherapy and trastuzumab-naive DCIS-Mi patients, human epidermal growth factor receptor2 (HER2) positivity (HR=21.8, 95%CI, 1.7-286.8, P=0.019) were independent predictor of worse DFS on multivariate analysis.

METHODS:

During September 2002 and December 2014, 602 breast cancer patients who underwent radical surgery were retrospectively reviewed. Three hundred and fifty-nine patients (59.6%) had pure DCIS, 84(14.0%) and 159(26.4%) were diagnosed as DCIS-Mi and DCIS-T1a. Clinico-pathological features were compared between different subgroups.

CONCLUSIONS:

DCIS-Mi displayed a comparable survival to that of DCIS-T1a and a more aggressive biological nature than pure DCIS. Patients with HER2-positive DCIS-Mi had a worse survival and adjuvant chemotherapy plus target therapy needs to be further optimized in those patients.

• Authors: Yan Fang, Jiayi Wu, Wei Wang, Xiaochun Fei, Yu Zong, Xiaosong Chen, Ou Huang, Jianrong He, Weiguo Chen, Yafen Li, Kunwei Shen, Li Zhu
• Journal: Oncotarget (Oncotarget) Vol. 7 Issue 39 Pg. 64182-64190 (Sep 27 2016) ISSN: 1949-2553 [Electronic] United States
• PMID: 27577080 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Biomarkers, Tumor
• ERBB2 protein, human
• Receptor, ErbB-2

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (analysis)
• Breast Neoplasms (chemistry, mortality, pathology, therapy)
• Carcinoma, Intraductal, Noninfiltrating (chemistry, mortality, pathology, therapy)
• Chemotherapy, Adjuvant
• Chi-Square Distribution
• Disease Progression
• Disease-Free Survival
• Female
• Humans
• Kaplan-Meier Estimate
• Mastectomy
• Middle Aged
• Multivariate Analysis
• Neoplasm Invasiveness
• Neoplasm Staging
• Proportional Hazards Models
• Receptor, ErbB-2 (analysis)
• Retrospective Studies
• Risk Factors
• Time Factors
• Treatment Outcome