Overview of the biology and management of ductal carcinoma in situ of the breast

Frykberg, F.A.C.S. Eric R.; Bland, F.A.C.S. Kirby I.

doi:10.1002/cncr.2820741321

Cited by 77 publications

(34 citation statements)

References 111 publications

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“…With the advent of screening mammography, the frequency with which ductal carcinoma in situ (DCIS) is detected has increased from approximately 1 to 20% of all breast cancers and is as high as 30% in some centres (Nemoto et al, 1980;Fryberg and Bland, 1994). Histological grade, lesion size and excision margin status are strongly related to the probability of developing local recurrence (Recht et al, 1985;Silverstein et al, 1995;Badve et al, 1998) and important in determining management.…”

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Vascular density and phenotype around ductal carcinoma in situ (DCIS) of the breast

et al. 2002

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Up to 50% of recurrences of ductal carcinoma in situ of the breast are associated with invasive carcinoma but no pathological or molecular features have yet been found to predict for the development of invasive disease. For a tumour to invade, it requires the formation of new blood vessels. Previous studies have described a vascular rim around ducts involved by ductal carcinoma in situ, raising the possibility that the characteristics of periductal vascularisation may be important in determining transformation from in situ to invasive disease. Periductal vascular density and phenotype were determined using morphometry and a panel of anti-endothelial antibodies (von Willebrand factor, CD31, CD141 and CD34) and related to the presence of invasive carcinoma and other histological features. Compared to normal lobules, pure ductal carcinoma in situ exhibited a greater density of CD34 + and CD31 + vessels but a decrease in those that were immunopositive for vWF, indicating a difference in phenotype and in density. Ductal carcinoma in situ associated with invasive carcinoma showed a profile of vascular immunostaining similar to that of pure ductal carcinoma in situ but there were significantly greater numbers of CD34 + and CD141 + vessels and fewer staining for vWF. There was a significant negative correlation between vascular density and both the cross-sectional areas of the ducts involved and the extent of the necrosis of the tumour they contained. A correlation between vascular density and nuclear grade was also noted, being highest in the intermediate grade. The greater density of CD34 + and CD141 + vessels around ductal carcinoma in situ associated with invasive carcinoma could reflect a greater predisposition to invade but a direct effect of co-existent invasive carcinoma cannot entirely be ruled out in the present study. The relationship between vascular density, grade, duct size and nuclear grade suggests that periductal angiogenesis increases with tumour growth rate but is unable to keep pace with the most rapidly growing lesions.

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Vascular density and phenotype around ductal carcinoma in situ (DCIS) of the breast

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“…Ductal carcinoma in situ (DCIS) of the breast, generally regarded as the precursor of most invasive breast cancers, has increased dramatically in incidence, due primarily to mammographic screening (1). In Singapore, it was found to comprise 25% of screen-detected breast cancers (2), with 94% of DCIS lesions associated with radiologic calcifications (3).…”

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Correlation of Nuclear Morphometry with Pathologic Parameters in Ductal Carcinoma In Situ of the Breast

et al. 2001

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Morphometric features of nuclear perimeter, nuclear area, feret ratio, and feret circle were studied in a series of 64 cases of ductal carcinoma in situ (DCIS) of the breast in Singapore women. The results were compared with pathologic parameters of tumor size, nuclear grade, necrosis, cell polarization, and architectural pattern. There was statistically significant correlation between nuclear perimeter and area with all the pathologic parameters, with the strongest association observed for nuclear grade (P < .0001). Higher grade nuclei as assessed histologically were associated with larger nuclear area ( Ductal carcinoma in situ (DCIS) of the breast, generally regarded as the precursor of most invasive breast cancers, has increased dramatically in incidence, due primarily to mammographic screening (1). In Singapore, it was found to comprise 25% of screen-detected breast cancers (2), with 94% of DCIS lesions associated with radiologic calcifications (3). Because it is a heterogeneous lesion, pathological classification schemes that attempt to define its biologic potential in terms of local recurrence and progression to invasive carcinoma have evolved, and debate continues as to the best system to adopt (4). Interobserver reproducibility studies have also been performed to define the system that allows the greatest concordance in pathologic assessment (5-8), with most advocating nuclear grade as the criterion that achieved the best agreement.In this paper, we document the correlation of pathologic variables determined from routine macroscopic and microscopic assessment of DCIS lesions with morphometric nuclear features derived quantitatively from image analysis. The aims are to investigate the association between histologically assigned nuclear grade and quantitative nuclear parameters, confirm its reproducibility with an objective imaging system, and define the relationship of other pathologic criteria with the nuclear morphometric findings. MATERIALS AND METHODS Patients, Tumors, and Pathological EvaluationThe study population comprised 64 women diagnosed with DCIS of the breast between 1993 and 1999, obtained from the files of the Department of Pathology, Singapore General Hospital. Tissues were fixed in 10% buffered formaldehyde (pH 7.0), embedded in paraffin, sectioned at 4 m, and stained with hematoxylin and eosin (H&E). The pathological features analyzed were tumor size, nuclear grade, presence or absence of necrosis or cell

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“…Handgeführte Stanzbiopsien sind genauer, wenn der Palpationsbefund gross ist (Â 3 ) 6 . Die dabei entnommenen Gewebezylinder werden histologisch untersucht.…”

Section: Eine Stanzbiopsie Kann Oft Malignität Bestätigen Oder Aber Aunclassified

“…Die ultraschallgeführte Stanzbiopsie liefert gleichwertige Resultate wie die Feinnadelpunktion [31]. 6 In einer Studie mit 150 Stanzbiopsien bei palpablen Tumoren war die Sensitivität 89%, ansteigend auf 94% bei Tumoren grösser als 2,5 cm im Durchmesser. Es gab kein falsch-positives Resultat [38].…”

Section: Das Exzisat Sollte Vollständig (Weder Zerstückelt Noch Eingeunclassified

Guideline zur Abklärung des palpablen Mammabefundes

2001

Gynäkol Geburtshilfliche Rundsch

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Overview of the biology and management of ductal carcinoma in situ of the breast

Cited by 77 publications

References 111 publications

Vascular density and phenotype around ductal carcinoma in situ (DCIS) of the breast

Vascular density and phenotype around ductal carcinoma in situ (DCIS) of the breast

Correlation of Nuclear Morphometry with Pathologic Parameters in Ductal Carcinoma In Situ of the Breast

Guideline zur Abklärung des palpablen Mammabefundes

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