Molecular Biomarkers of Risk in Premalignancy and Breast Cancer Prevention

Allred, D. Craig

doi:10.1158/1940-6207.capr-11-0478

Cited by 5 publications

(2 citation statements)

References 38 publications

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“…The histological criteria for ADH have been clearly defined as the involvement of no more than one terminal ductal lobular unit or low-grade intraductal proliferation with a maximum size of 2 mm, and a failure to meet all the criteria for low-grade ductal carcinoma in situ (DCIS) [ 1 ]. The definition of ADH is similar to that of low-grade DCIS, and the clinical management strategy has been surgery for over 2 decades, because the risk of underestimating the disease is 20–30%, calculated from a comparison of the diagnosis based on needle biopsy and the subsequent analysis of surgical specimens [ 2 , 5 , 6 ]. However, in recent years, there has been an increasing debate over whether all ADH lesions should be treated surgically or in select cases, should receive only follow-up after a radiographically identified lesion has been removed by vacuum-assisted biopsy (VAB) [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Atypical ductal hyperplasia and the risk of underestimation: tissue sampling method, multifocality, and associated calcification significantly influence the diagnostic upgrade rate based on subsequent surgical specimens

et al. 2018

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Background Risk assessment and therapeutic options are challenges when counselling patients with an atypical ductal hyperplasia (ADH) to undergo either open surgery or follow-up only. Methods We retrospectively analyzed a series of ADH lesions and assessed whether the morphological parameters of the biopsy materials indicated whether the patient should undergo surgery. A total of 207 breast biopsies [56 core needle biopsies (CNBs) and 151 vacuum-assisted biopsies (VABs)] histologically diagnosed as ADH were analyzed retrospectively, together with subsequently obtained surgical specimens. All histological slides were re-analyzed with regard to the presence/absence of ADH-associated calcification, other B3 lesions (lesion of uncertain malignant potential), extent of the lesion, and the presence of multifocality. Results The overall underestimation rate for the whole cohort was 39% (57% for CNB, 33% for VAB). In the univariate analysis, the method of biopsy (CNB vs VAB, p = 0.002) and presence of multifocality in VAB specimens ( p = 0.0176) were significant risk factors for the underestimation of the disease (ductal carcinoma in situ or invasive cancer detected on subsequent open biopsy). In the multivariate logistic regression model, the absence of calcification ( p = 0.0252) and the presence of multifocality (unifocal vs multifocal ADH, p = 0.0147) in VAB specimens were significant risk factors for underestimation. Conclusions Multifocal ADH without associated calcification diagnosed by CNB tends to have a higher upgrade rate. Because the upgrade rate was 16.5% even in the group with the lowest risk (VAB-diagnosed unifocal ADH with calcification), we could not identify a subgroup that would not require an open biopsy.

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Section: Introductionmentioning

confidence: 99%

Atypical ductal hyperplasia and the risk of underestimation: tissue sampling method, multifocality, and associated calcification significantly influence the diagnostic upgrade rate based on subsequent surgical specimens

et al. 2018

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“…Presently, there isn’t a single molecular marker able to detect early stage breast tissue changes or predict with accuracy the biological potential of breast lesions [30] – [32] . Moreover, for almost all cancer types, the protein biomarkers that have been identified to date do not possess the sensitivity and/or specificity required to have clinical utility individually.…”

Section: Introductionmentioning

confidence: 99%

Immunoexpression Analysis and Prognostic Value of BLCAP in Breast Cancer

et al. 2012

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Bladder Cancer Associated Protein (BLCAP, formerly Bc10), was identified by our laboratory as being down-regulated in bladder cancer with progression. BLCAP is ubiquitously expressed in different tissues, and several studies have found differential expression of BLCAP in various cancer types, such as cervical and renal cancer, as well as human tongue carcinoma and osteosarcoma. Here we report the first study of the expression patterns of BLCAP in breast tissue. We analyzed by immunohistochemistry tissue sections of normal and malignant specimens collected from 123 clinical high-risk breast cancer patients within the Danish Center for Translational Breast Cancer Research (DCTB) prospective study dataset. The staining pattern, the distribution of the immunostaining, and its intensity were studied in detail. We observed weak immunoreactivity for BLCAP in mammary epithelial cells, almost exclusively localizing to the cytoplasm and found that levels of expression of BLCAP were generally higher in malignant cells as compared to normal cells. Quantitative IHC analysis of BLCAP expression in breast tissues confirmed this differential BLCAP expression in tumor cells, and we could establish, in a 62-patient sample matched cohort, that immunostaining intensity for BLCAP was increased in tumors relative to normal tissue, in more than 45% of the cases examined, indicating that BLCAP may be of value as a marker for breast cancer. We also analyzed BLCAP expression and prognostic value using a set of tissue microarrays comprising an independent cohort of 2,197 breast cancer patients for which we had follow-up clinical information.

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Prognostic value of COX‐2, P53, and EZH‐2 evaluated by quantitative image analysis in premalignant and malignant breast lesions

Nicolopoulou-Stamati

Tsipis

Chelidonis

et al. 2014

Diagnostic Cytopathology

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Molecular Biomarkers of Risk in Premalignancy and Breast Cancer Prevention

Abstract: About 50,000 U.S. women are diagnosed with breast atypical hyperplasia each year, giving them about a six-fold increased relative risk of developing invasive breast cancer (IBC) compared with age-matched controls.

Cited by 5 publications

References 38 publications

Atypical ductal hyperplasia and the risk of underestimation: tissue sampling method, multifocality, and associated calcification significantly influence the diagnostic upgrade rate based on subsequent surgical specimens

Atypical ductal hyperplasia and the risk of underestimation: tissue sampling method, multifocality, and associated calcification significantly influence the diagnostic upgrade rate based on subsequent surgical specimens

Immunoexpression Analysis and Prognostic Value of BLCAP in Breast Cancer

Prognostic value of COX‐2, P53, and EZH‐2 evaluated by quantitative image analysis in premalignant and malignant breast lesions

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