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Molecular subtypes in ductal carcinoma in situ of the breast and their relation to prognosis: a population-based cohort study

Zhou, Wenjing ; Jirström, Karin LU ; Amini, Rose-Marie ; Fjallskog, Marie-Louise ; Sollie, Thomas ; Lindman, Henrik ; Sorlie, Therese ; Blomqvist, Carl and Warnberg, Fredrik (2013) In BMC Cancer 13.
Abstract
Background: Different molecular subtypes of breast cancer have been identified based on gene expression profiling. Treatment suggestions based on an approximation of these subtypes by immunohistochemical criteria have been published by the St Gallen international expert consensus panel. Ductal carcinoma in situ (DCIS) can be classified into the same molecular subtypes. Our aim was to study the relation between these newly defined subtypes and prognosis in DCIS. Methods: TMA including 458 women from a population-based cohort with DCIS diagnosed 1986-2004 was used. Stainings for ER, PR, HER2 and Ki67 were used to classify the surrogate molecular subtypes according to the St Gallen criteria from 2011. The associations with prognosis were... (More)
Background: Different molecular subtypes of breast cancer have been identified based on gene expression profiling. Treatment suggestions based on an approximation of these subtypes by immunohistochemical criteria have been published by the St Gallen international expert consensus panel. Ductal carcinoma in situ (DCIS) can be classified into the same molecular subtypes. Our aim was to study the relation between these newly defined subtypes and prognosis in DCIS. Methods: TMA including 458 women from a population-based cohort with DCIS diagnosed 1986-2004 was used. Stainings for ER, PR, HER2 and Ki67 were used to classify the surrogate molecular subtypes according to the St Gallen criteria from 2011. The associations with prognosis were examined using Kaplan-Meier analyses and Cox proportional hazards regression models. Results: Surrogate molecular subtyping could be done in 381 cases. Mean follow up was 164 months. Of the classified DCIS 186 were Luminal A (48.8%), 33 Luminal B/HER2-(8.7%), 74 Luminal B/HER2+ (17.4%), 61 HER2+/ER-(16.0%) and 27 Triple Negative (7.1%). One hundred and two women had a local recurrence of which 58 were invasive. Twenty-two women had generalised disease, 8 without a prior local recurrence. We could not find a prognostic significance of the molecular subtypes other than a higher risk of developing breast cancer after more than 10 years of follow-up among women with a Triple Negative DCIS (OR 3.2; 95% CI 1.1-9.8). Conclusions: The results from this large population-based cohort, with long-term follow up failed to demonstrate a prognostic value for the surrogate molecular subtyping of DCIS using the St Gallen criteria up to ten years after diagnosis. More than ten years after diagnosis Triple Negative DCIS had an elevated risk of recurrence. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
BMC Cancer
volume
13
article number
512
publisher
BioMed Central (BMC)
external identifiers
  • wos:000329025500004
  • scopus:84886497066
  • pmid:24171825
ISSN
1471-2407
DOI
10.1186/1471-2407-13-512
language
English
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yes
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The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pathology, (Lund) (013030000)
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c33b0587-679c-41fa-8d1b-9742806d1f14 (old id 4261682)
date added to LUP
2016-04-01 14:04:26
date last changed
2020-07-08 02:27:34
@article{c33b0587-679c-41fa-8d1b-9742806d1f14,
  abstract     = {Background: Different molecular subtypes of breast cancer have been identified based on gene expression profiling. Treatment suggestions based on an approximation of these subtypes by immunohistochemical criteria have been published by the St Gallen international expert consensus panel. Ductal carcinoma in situ (DCIS) can be classified into the same molecular subtypes. Our aim was to study the relation between these newly defined subtypes and prognosis in DCIS. Methods: TMA including 458 women from a population-based cohort with DCIS diagnosed 1986-2004 was used. Stainings for ER, PR, HER2 and Ki67 were used to classify the surrogate molecular subtypes according to the St Gallen criteria from 2011. The associations with prognosis were examined using Kaplan-Meier analyses and Cox proportional hazards regression models. Results: Surrogate molecular subtyping could be done in 381 cases. Mean follow up was 164 months. Of the classified DCIS 186 were Luminal A (48.8%), 33 Luminal B/HER2-(8.7%), 74 Luminal B/HER2+ (17.4%), 61 HER2+/ER-(16.0%) and 27 Triple Negative (7.1%). One hundred and two women had a local recurrence of which 58 were invasive. Twenty-two women had generalised disease, 8 without a prior local recurrence. We could not find a prognostic significance of the molecular subtypes other than a higher risk of developing breast cancer after more than 10 years of follow-up among women with a Triple Negative DCIS (OR 3.2; 95% CI 1.1-9.8). Conclusions: The results from this large population-based cohort, with long-term follow up failed to demonstrate a prognostic value for the surrogate molecular subtyping of DCIS using the St Gallen criteria up to ten years after diagnosis. More than ten years after diagnosis Triple Negative DCIS had an elevated risk of recurrence.},
  author       = {Zhou, Wenjing and Jirström, Karin and Amini, Rose-Marie and Fjallskog, Marie-Louise and Sollie, Thomas and Lindman, Henrik and Sorlie, Therese and Blomqvist, Carl and Warnberg, Fredrik},
  issn         = {1471-2407},
  language     = {eng},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Cancer},
  title        = {Molecular subtypes in ductal carcinoma in situ of the breast and their relation to prognosis: a population-based cohort study},
  url          = {https://lup.lub.lu.se/search/ws/files/3762903/4588203},
  doi          = {10.1186/1471-2407-13-512},
  volume       = {13},
  year         = {2013},
}