Noninvasive ductal carcinoma of the breast: The relevance of histologic categorization

Bellamy, Christopher; McDonald, C.; Salter, Donald; Chetty, U.; Anderson, Thomas

doi:10.1016/0046-8177(93)90057-n

Cited by 235 publications

(89 citation statements)

References 22 publications

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“…All tissues were ®xed for a minimum of 24 h in bu ered formalin (0.4% sodium acid phosphate, 0.65% sodium phosphate) prior to wax embedding. In all cases, the histological classi®cation by nuclear grade (Bellamy et al, 1993, NHSBSP Publication No 3, 1995 and growth pattern of the tumour was con®rmed by one of us (LM). Of the cases, ®ve were pure DCIS and did not contain an invasive component while in four cases small foci of invasion were present.…”

Section: Patient Materialsmentioning

confidence: 83%

Comparative genomic hybridisation of ductal carcinoma in situ of the breast: identification of regions of DNA amplification and deletion in common with invasive breast carcinoma

et al. 1997

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Comparative genomic hybridisation has been used to map copy number changes in nine cases of ductal carcinoma in situ of the breast obtained from waxembedded archive material. A wide variety of abnormalities were detected including gain of regions of 1q, 17q, 19q, 20p and 20q and loss on 13q, 14q, 17p, 16q and 22q. Ampli®cation of areas on 10p, 8q and 20q were also observed. Chromosomal alterations were more frequent in higher grade DCIS and closely resemble those previously detected in invasive breast cancer using the same technique. These data provide strong molecular support for the view that DCIS is a precursor lesion of invasive breast carcinoma.

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Section: Patient Materialsmentioning

confidence: 83%

Comparative genomic hybridisation of ductal carcinoma in situ of the breast: identification of regions of DNA amplification and deletion in common with invasive breast carcinoma

et al. 1997

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“…Our study shows that in four of the five institutes clinicians did not enter eligible patients based on the histologic subtype of DCIS. Results of non-randomised studies based on (morphologic) classification of DCIS (Page et al, 1982;Lagios et al, 1989;Silverstein et al, 1990;Bellamy et al, 1993;Eusebi et al, 1994) have influenced the participating clinicians' opinions on the treatment of subtypes of the disease. Of all randomised patients the histology was reviewed.…”

Section: Discussionmentioning

confidence: 99%

Effects of patient selection on the applicability of results from a randomised clinical trial (EORTC 10853) investigating breast-conserving therapy for DCIS

et al. 2002

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Selection of patients for randomised clinical trials may have a large impact on the applicability of the study results to the general population presenting the same disorder. However, clinical characteristics and outcome data on non-entered patients are usually not available. The effects of patient selection for the EORTC 10853 trial investigating the role of radiotherapy in breast conserving therapy for ductal carcinoma in situ have been studied, in an analysis of all patients treated for ductal carcinoma in situ in five participating institutes. The reasons for not entering patients were evaluated and treatment results of the randomised patients were compared to those not entered. A total of 910 patients were treated for ductal carcinoma in situ. Of these, 477 (52%) were ineligible, with the size of the lesion being the main reason for ineligibility (30% of all ductal carcinoma in situ). Of the 433 eligible patients, 278 (64%) were randomised into the trial. The main reasons for non-entry of eligible patients were either physicians' preference for one of the treatment arms (26%) or patients' refusal (9%). These percentages showed significant variation among the institutes. At 4 years follow-up, those patients not entered in the trial and treated with local excision and radiotherapy, had higher local recurrence rates than the patients randomised in the trial and treated with the same approach, (17 vs 2%, P=0.03). The patients treated with local excision alone had equal local recurrence rates (11% in both groups). Selection of patients may explain the differences in outcome of the randomised patients, and those not-entered. Thus, the results of this trial may not be applicable to all patients with ductal carcinoma in situ.

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“…The recent publications of many different subclassifications of DCIS (15,(21)(22)(23)(24)(25)(26) reflect an effort to have a reproducible system of grading. These subclassifications of DCIS are overall based on nuclear criteria that are subjectively evaluated within the limits of visual subjective assessment.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Study of Breast Cancer Progression: Different Pathways for Various In Situ Cancers

et al. 2002

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Breast cancer is known to progress through multiple, genomic changes (1-11). These accumulating changes result in the nuclear alterations on which the pathologic diagnosis and microscopic prognosis of cancer are based. The natural history of ductal breast cancer is, even today, only incompletely known. The suggestion that a clonal selection (12) occurs in the progression from atypical hyperplasia toward ductal carcinoma in situ (DCIS) and invasive cancers seems to be supported by recent cytogenetic and molecular studies (1,13,14) and also by the characteristic morphological heterogeneity (15) of various ductal proliferative premalignant lesions. We studied alterations of the nuclear chromatin pattern concomitant with the development of different histologically defined diagnostic categories in ductal proliferative lesion progression. Recent work led to the development of methods allowing a more extensive use of information extracted from diagnostic imagery. One such method is the characterization of individual nuclei, of sets of nuclei, and of entire lesions by a "signature." These signatures are based on a substantial number of karyometric features, for each of which a measure of deviation from "normal" is computed. The deviation values are arranged in the form of a profile (16).In earlier studies, these procedures were applied to images of nuclei from ductal proliferating breast lesions and DCIS (17,18). It was shown that nuclei from a number of the conventional diagnostic categories of proliferating breast lesions representing breast cancer progression are characterized by a monotonically increasing nuclear abnormality. The histologically defined subjective diagnostic categories, ordered by relative risk for development of

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Noninvasive ductal carcinoma of the breast: The relevance of histologic categorization

Cited by 235 publications

References 22 publications

Comparative genomic hybridisation of ductal carcinoma in situ of the breast: identification of regions of DNA amplification and deletion in common with invasive breast carcinoma

Comparative genomic hybridisation of ductal carcinoma in situ of the breast: identification of regions of DNA amplification and deletion in common with invasive breast carcinoma

Effects of patient selection on the applicability of results from a randomised clinical trial (EORTC 10853) investigating breast-conserving therapy for DCIS

Quantitative Study of Breast Cancer Progression: Different Pathways for Various In Situ Cancers

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