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Predicting relapse in ductal carcinoma in situ patients: an analysis of biologic markers with long-term follow-up.

Hieken TJ, Cheregi J, Farolan M, Kim J, Velasco JM

Department of Surgery, Rush North Shore Medical Center, 9669 North Kenton Avenue, Suite 204, Skokie, IL 60076, USA. thieken@rush.edu

BACKGROUND: The incidence of ductal carcinoma in situ (DCIS) of the breast is increasing. Optimal treatment remains controversial and, because of a long natural history, may not be evident for many years. We undertook this study to identify markers of disease recurrence. METHODS: We studied 131 pure DCIS patients with a 100-month mean follow-up. We performed a complete histologic review, immunohistochemical staining for p53 and vascular endothelial growth factor expression, and enumerated microvessel density/mm2 using factor VIII-Ab. Statistical analysis was performed by using an SAS software package (Cary, NC). RESULTS: Eleven patients (8%) developed ipsilateral recurrence at a mean of 55 months (11-137 months) after initial treatment. Three were DCIS, and 8 were invasive cancer. Recurrence was significantly predicted by p53 overexpression (in 55% of tumors that recurred versus 22% of those that did not, P = .02) but not other factors. CONCLUSIONS: These data suggest that biologic factors may have an important role in predicting recurrence in DCIS patients.

Published 10 September 2007 in Am J Surg, 194(4): 504-6.
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