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The clinical significance of oestrogen receptor expression in breast ductal carcinoma in situ
- Source :
- Br J Cancer, British Journal of Cancer
- Publication Year :
- 2020
-
Abstract
- Background Oestrogen receptor (ER) in invasive breast cancer (BC) predicts response to endocrine therapy (ET) and provides prognostic value. In this study, we investigated the value of ER expression in ductal carcinoma in situ (DCIS) in terms of outcome and the impact on ET decision. Methods In total, 643 pure DCIS, diagnosed at Nottingham University Hospitals, were assessed for ER. Clinicopathological data were correlated against ER status, together with assessment of recurrence rate. Results ER positivity was observed in 74% (475/643) of cases. ER positivity was associated with clinicopathological variables of good prognosis; however, outcome analysis revealed that ER status was not associated with local recurrence. In the intermediate- and high-grade ER-positive DCIS, 58% (11/19) and 63% (15/24) of the recurrences were invasive, respectively, comprising 7% and 6% of all ER-positive DCIS, respectively. Invasive recurrence in low-grade DCIS was infrequent (2%), and none of these patients died of BC. The ER status of the recurrent invasive tumours matched the primary DCIS ER status (94% in ipsilateral and 90% of contralateral recurrence). Conclusion The strong correlation between DCIS and invasive recurrence ER status and the clinical impact of ET justify discussion of the use of ET in ER-positive DCIS treated by breast-conserving surgery. The excellent outcome of low-grade DCIS, which was almost always ER-positive, does not, in the opinion of authors, justify the use of risk-reducing ET. Therefore, the decision on ET for DCIS should be personalised and consider grade, ER status and other characteristics.
- Subjects :
- Oncology
Adult
Cancer Research
medicine.medical_specialty
Antineoplastic Agents, Hormonal
medicine.medical_treatment
Breast Neoplasms
Article
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Breast cancer
Predictive Value of Tests
Internal medicine
Carcinoma
Biomarkers, Tumor
Medicine
Humans
Clinical significance
skin and connective tissue diseases
Survival analysis
Aged
Retrospective Studies
Aged, 80 and over
Chemotherapy
business.industry
Carcinoma, Ductal, Breast
Correction
Retrospective cohort study
Ductal carcinoma
Middle Aged
medicine.disease
Prognosis
Survival Analysis
Treatment Outcome
Receptors, Estrogen
Chemotherapy, Adjuvant
Tissue Array Analysis
030220 oncology & carcinogenesis
Predictive value of tests
Female
business
Carcinoma in Situ
Subjects
Details
- ISSN :
- 15321827
- Volume :
- 123
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- British journal of cancer
- Accession number :
- edsair.doi.dedup.....a8c08b0b67cc446b08419874927b8bbe