Abstract
Ductal breast carcinoma in situ (DCIS) is regarded as a precursor to invasive breast cancer. The progression from in situ to invasive cancer is however little understood. We compared some tumour markers in invasive and in situ breast carcinomas trying to find steps in this progression. We designed a semi-experimental setting and compared histopathological grading and tumour marker expression in pure DCIS (n = 194), small invasive lesions (n = 127) and lesions with both an invasive and in situ component (n = 305). Grading was done according to the Elston–Ellis and EORTC classification systems, respectively. Immunohistochemical staining was conducted for p53, c-erbB-2, Ki-67, ER, PR, bcl-2 and angiogenesis. All markers correlated with grade rather than with invasiveness. No marker was clearly associated with the progression from in situ to invasiveness. The expression of tumour markers was almost identical in the 2 components of mixed lesions. DCIS as a group showed a more ‘malignant picture’ than invasive cancer according to the markers, probably, due to a higher proportion of poorly differentiated lesions. The step between in situ and invasive cancer seems to occur independently of tumour grade. The results suggest that well-differentiated DCIS progress to well-differentiated invasive cancer and poorly differentiated DCIS progress to poorly differentiated invasive cancer. © 2001 Cancer Research Campaign http://www.bjcancer.com
Similar content being viewed by others
Article PDF
Change history
16 November 2011
This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication
References
Allred DC et al (1992) Overexpression of HER-2/neu and its relationship with other prognostic factors change during the progression of in situ to invasive breast cancer. Hum Pathol 23: 974–979
Andersen J, Nielsen M and Christensen L (1985) New aspects of the natural history of in situ and invasive carcinoma in the female breast. Results from autopsy investigations. Verh Dtsch Ges Path 69: 88–95
Bradley SJ and Weaver DW et al (1990) Alternatives in the surgical management of in situ breast cancer. A meta-analysis of outcome. Am Surgeon 56: 428–432
Buerger H et al (1999) Comparative genomic hybridization of ductal carcinoma in situ of the breast – evidence of multiple genetic pathways. J Pathol 187: 396–402
Douglas-Jones AG et al (1996) A critical appraisal of six modern classifications of ductal carcinoma in situ of the breast (DCIS): correlation with grade of associated invasive carcinoma. Histopathol 29: 397–409
Elston CW et al (1991) Pathological prognostic factors in breast cancer I. The value of histological grade in breast cancer: experience from a large study with long term follow up. Histopathol 19: 403–410
Engels K et al (1997) Distinct angiogenic patterns are associated with high-grade in situ ductal carcinomas of the breast. J Pathol 181: 207–212
Fisher B et al (1993) Lumpectomy compared with lumpectomy and radiation therapy for the treatment of intraductal breast cancer. N Engl J Med 328: 1581–1586
Fox SB et al (1995) Quantitation and prognostic value of breast cancer angiogenesis: comparison of microvessel density, Chalkley count, and computer image analysis. J Pathol 177: 275–283
Graham MD, Lakhani S and Gazet JC (1991) Breast conserving surgery in the management of in situ breast carcinoma. Eur J Surg Oncol 17: 258–264
Guidi AJ et al (1994) Microvessel density and distribution in ductal carcinoma in situ of the breast. J Nat Cancer Inst 86: 614–619
Gupta SK et al (1997) The clinical of breast carcinoma is probably determined at the preinvasive stage (ductal carcinoma in situ). Cancer 80: 1740–1745
Holland R et al (1994) Ductal carcinoma in situ: A proposal for a new classification. Sem Diag Pathol 11: 167–180
Iglehart JD et al (1995) Maintenance of DNA content and erbB-2 alterations in intraductal and invasive phases of mammary cancer. Breast Cancer Res Treat 34: 253–263
Leal CB et al (1995) Ductal carcinoma in situ of the breast. Histologic categorization and its relationship to ploidy and immunohistochemical expression of hormone receptors, p53, and c-erbB-2 Protein. Cancer 75: 2123–2131
Page DL et al (1982) Intraductal carcinoma of the breast: Follow-up after biopsy only. Cancer 49: 751–758
Price P et al (1990) Duct carcinoma in situ: predictors of local recurrence and progression in patients treated by surgery alone. Br J Cancer 61: 869–872
Rosen PP, Braun DW and Kinne DE (1980) The clinical significance of pre-invasive breast carcinoma. Cancer 46: 919–925
Solin LJ et al (1996) Fifteen-year results of breast-conserving surgery and definitive breast irradiation for the treatment of ductal carcinoma in situ of the breast. J Clin Oncol 14: 754–763
Somerville JE, Clarke LA and Biggart JD (1992) C-erbB-2 overexpression and histological type of in situ and invasive breast carcinoma. J Clin Pathol 45: 16–20
Stomper PC et al (1989) Clinically occult ductal carcinoma in situ detected with mammography: analysis of 100 cases with radiologic-pathologic correlation. Radiology 172: 235–241
Swain SM et al (1992) Ductal carcinoma in situ. Cancer Invest 10: 443–454
Author information
Authors and Affiliations
Rights and permissions
From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
About this article
Cite this article
Wärnberg, F., Nordgren, H., Bergkvist, L. et al. Tumour markers in breast carcinoma correlate with grade rather than with invasiveness. Br J Cancer 85, 869–874 (2001). https://doi.org/10.1054/bjoc.2001.1995
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1054/bjoc.2001.1995
Keywords
This article is cited by
-
Role of Plasma D-Dimer Levels in Breast Cancer Patients and Its Correlation with Clinical and Histopathological Stage
Indian Journal of Surgical Oncology (2018)
-
The prognostic role of HER2 expression in ductal breast carcinoma in situ (DCIS); a population-based cohort study
BMC Cancer (2015)
-
Molecular subtypes in ductal carcinoma in situ of the breast and their relation to prognosis: a population-based cohort study
BMC Cancer (2013)
-
New Treatment Paradigms for Patients with Ductal Carcinoma In Situ
Current Breast Cancer Reports (2013)
-
Coexisting ductal carcinoma in situ independently predicts lower tumor aggressiveness in node-positive luminal breast cancer
Medical Oncology (2012)