Can Biomarkers Predict DCIS Behavior?
Although ductal carcinoma in situ (DCIS) is a relatively common diagnosis, there are currently no validated methods to predict the risk of subsequent invasive cancer for women diagnosed with DCIS. It is estimated that 5% to 10% of women with DCIS treated with lumpectomy alone develop a subsequent invasive breast cancer within 5 years, and another 5% to 10% develop a subsequent DCIS. To identify clinical, histopathologic, and molecular characteristics of initial DCIS lesions that might distinguish patients with a low risk versus a high risk of developing subsequent invasive breast cancer, Kerlikowske and colleagues conducted a case-controlled, retrospective study in a cohort of 1162 women who were diagnosed with DCIS and treated by lumpectomy alone from 1983 to 1994. Pathology review of initial paraffin-embedded DCIS tissue and immunohistochemistry to determine biomarkers (ER, PR, HER2, Ki67, p53, p16, and cyclooxygenase-2 [COX2]) in a subset of the reviewed cases was performed. Of the
