Immunohistochemical Biomarkers in Ductal Carcinoma <i>In Situ</i>

Abstract

Introduction: Breast ductal carcinoma in situ (DCIS) can be defined as a malignant epithelial proliferation with growth limited by the basal membrane of the ductal epithelium, with no evidence of stromal invasion. There has been a trend of trying to subcategorize DCIS based on cell proliferation assays (Ki67) and the expression of hormone receptors and the human epidermal growth receptor (HER-2) as detected by immunohistochemistry, similar to invasive breast carcinomas (IBC). The aims were to evaluate the expression of breast cancer marker proteins in DCIS by immunohistochemistry to better categorize it. Methods: 46 biopsies from women with DCIS and IBC Luminal Alike were evaluated by immunohistochemistry staining of proteins already known to be biomarkers in IBC. For controls, normal breast tissue from mammoplasty (n = 3) was used. Results: Our results showed an increase of estrogen receptor (ER) and progesterone receptor (PR) expression relative to that in normal tissue samples (p < 0.0001). No differences in steroid hormone expression patterns were seen between DCIS and IBC tumors (p = 0.3145; p = 0.7341, respectively). The proliferation levels of the DCIS and IBC samples were similar as evaluated by the Ki67 labeling index. Only 12.90% of samples showed amplification of HER-2. Conclusion: The biology of DCIS is not well understood given the complexity and heterogeneity of the disease, which makes it important to better subcategorize this tumor, especially considering the possibility of identifying DCIS cases with the potential for recurrence and evolution into IBC.

MTHFR C677T and A1298C Polymorphisms in Breast Cancer, Gliomas and Gastric Cancer: A Review

“…Genomic studies have increased the knowledge about the heterogeneity of BC, allowing its classification into four intrinsic subtypes of invasive tumors (IBCs) based on receptor expression: luminal A, characterized by the expression of estrogen and/or progesterone receptors (ER/PR); luminal HER, characterized by the expression of ER and/or PR and human epidermal growth factor receptor 2 (HER-2); HER-2, characterized by HER-2 overexpression and the absence of ER and PR; and the triple-negative (TN) subtype, which does not express any of these three receptors [ 61 , 62 ]. Ductal carcinoma in situ (DCIS) is a noninvasive BC type that can evolve to invasive types, has been molecular characterized similarly and has been described as a possible invasive precursor of breast tumorigenesis, although this classification and the potential to become invasive remain controversial in the literature [ 63 ].…”

Clinicopathological characteristics and recurrence risk in patients with ductal carcinoma in situ of the breast

“…In low-income countries, the current DCIS detection rate remains similar to the detection rate in European countries before the implementation of the breast cancer screening program 25 . A few studies characterizing the clinicopathological characteristics of DCIS in Brazil have been published, and none has investigated the efficacy of the treatment in a long-term follow-up [26][27][28] . Investigating the clinical and pathological features of women diagnosed with DCIS in developing countries is crucial to the management decision in the current and the near future scenario for DCIS treatment.…”

Epigenetic Alterations in DCIS Progression: What Can lncRNAs Teach Us?

“…In addition to invasive tumors, ductal carcinoma in situ (DCIS) is a noninvasive BC type that can progress to invasive types and has been similarly molecularly classified. DCIS has been described as a possible invasive precursor of breast tumorigenesis, although this classification and its potential to become invasive remain controversial in the literature [31].…”

“…DCIS has atypical epithelial proliferation, with limited growth by the ductal epithelial basement membrane without evidence of stromal invasion. It is considered a preinvasive BC lesion and a heterogeneous disease that has increased in frequency and clinical relevance following the advent of mammographic screening [31]. The current standard of care for DCIS is an aggressive course of therapy to prevent invasive and metastatic disease, resulting in overdiagnosis and overtreatment, although the mortality rate is relatively low.…”