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Clonal alteration of breast cancer receptors between primary ductal carcinoma in situ (DCIS) and corresponding local events

Karlsson, E.; Sandelin, K.; Appelgren, J.; Zhou, W.; Jirström, Karin LU ; Bergh, J. and Warnberg, F. (2014) In European Journal of Cancer 50(3). p.517-524
Abstract
Background: Emerging data propose biomarker alteration due to clonal selection between the primary invasive breast cancer and corresponding metastases. In addition, impact on survival has been demonstrated. The present study investigates the relationship between the oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) between primary ductal carcinoma in situ (DCIS) and intra-individually matched ipsilateral event. Materials and methods: The cohort includes 1504 patients, diagnosed with a primary DCIS between 1986 and 2004. Of the 274 patients who developed a local relapse, 135 developed a new in situ carcinoma and 139 an invasive cancer up to 31st December 2011. ER and PR were identified... (More)
Background: Emerging data propose biomarker alteration due to clonal selection between the primary invasive breast cancer and corresponding metastases. In addition, impact on survival has been demonstrated. The present study investigates the relationship between the oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) between primary ductal carcinoma in situ (DCIS) and intra-individually matched ipsilateral event. Materials and methods: The cohort includes 1504 patients, diagnosed with a primary DCIS between 1986 and 2004. Of the 274 patients who developed a local relapse, 135 developed a new in situ carcinoma and 139 an invasive cancer up to 31st December 2011. ER and PR were identified by immunohistochemistry (IHC) and HER2 by silver-enhanced in situ hybridisation (SISH) as well as IHC. Results: ER (n = 112), PR (n = 113) and HER2 (n = 114) status from both the primary DCIS and the corresponding relapse were assessed and were demonstrated to be discordant in 15.1%, 29.2% and 10.5% respectively. The receptor conversion was both from negative to positive and from positive to negative with no general pattern being seen in spite of sub-dividing into in situ relapse and invasive relapse. However, primary DCIS was HER2 positive in 40.3% whereas in situ and invasive relapses were HER2 positive in 42.9% and 34.5% respectively. Conclusions: Receptor conversion for ER, PR and HER2 status occurred between primary DCIS and corresponding local relapse in 10-30%. This study could not confirm that HER2 overexpression in primary DCIS had any impact on tumour progression to invasive cancer which has been proposed. (C) 2013 Elsevier Ltd. All rights reserved. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
Ductal carcinoma in situ, DCIS, Breast cancer, Hormonal receptor, ER, Oestrogen receptor, PR, Progesterone receptor, Human epidermal growth, factor receptor 2, HER2
in
European Journal of Cancer
volume
50
issue
3
pages
517 - 524
publisher
IFAC & Elsevier Ltd.
external identifiers
  • wos:000330184400006
  • scopus:84893691711
ISSN
1879-0852
DOI
10.1016/j.ejca.2013.10.020
language
English
LU publication?
yes
id
6e30f6cc-fb73-4e61-aa6f-b5b04bf32548 (old id 4318529)
date added to LUP
2014-03-03 08:02:48
date last changed
2017-11-12 03:03:18
@article{6e30f6cc-fb73-4e61-aa6f-b5b04bf32548,
  abstract     = {Background: Emerging data propose biomarker alteration due to clonal selection between the primary invasive breast cancer and corresponding metastases. In addition, impact on survival has been demonstrated. The present study investigates the relationship between the oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) between primary ductal carcinoma in situ (DCIS) and intra-individually matched ipsilateral event. Materials and methods: The cohort includes 1504 patients, diagnosed with a primary DCIS between 1986 and 2004. Of the 274 patients who developed a local relapse, 135 developed a new in situ carcinoma and 139 an invasive cancer up to 31st December 2011. ER and PR were identified by immunohistochemistry (IHC) and HER2 by silver-enhanced in situ hybridisation (SISH) as well as IHC. Results: ER (n = 112), PR (n = 113) and HER2 (n = 114) status from both the primary DCIS and the corresponding relapse were assessed and were demonstrated to be discordant in 15.1%, 29.2% and 10.5% respectively. The receptor conversion was both from negative to positive and from positive to negative with no general pattern being seen in spite of sub-dividing into in situ relapse and invasive relapse. However, primary DCIS was HER2 positive in 40.3% whereas in situ and invasive relapses were HER2 positive in 42.9% and 34.5% respectively. Conclusions: Receptor conversion for ER, PR and HER2 status occurred between primary DCIS and corresponding local relapse in 10-30%. This study could not confirm that HER2 overexpression in primary DCIS had any impact on tumour progression to invasive cancer which has been proposed. (C) 2013 Elsevier Ltd. All rights reserved.},
  author       = {Karlsson, E. and Sandelin, K. and Appelgren, J. and Zhou, W. and Jirström, Karin and Bergh, J. and Warnberg, F.},
  issn         = {1879-0852},
  keyword      = {Ductal carcinoma in situ,DCIS,Breast cancer,Hormonal receptor,ER,Oestrogen receptor,PR,Progesterone receptor,Human epidermal growth,factor receptor 2,HER2},
  language     = {eng},
  number       = {3},
  pages        = {517--524},
  publisher    = {IFAC & Elsevier Ltd.},
  series       = {European Journal of Cancer},
  title        = {Clonal alteration of breast cancer receptors between primary ductal carcinoma in situ (DCIS) and corresponding local events},
  url          = {http://dx.doi.org/10.1016/j.ejca.2013.10.020},
  volume       = {50},
  year         = {2014},
}