Abstract
Ductal carcinoma in situ (DCIS) accounts for approximately 20% of mammographically detected breast cancers. Although DCIS is generally highly curable, some women with DCIS will develop life-threatening invasive breast cancer, but the determinants of progression to infiltrating ductal cancer (IDC) are largely unknown. In the current study, we used multiplex ligation-dependent probe amplification (MLPA), a multiplex PCR-based test, to compare copy numbers of 21 breast cancer related genes between laser-microdissected DCIS and adjacent IDC lesions in 39 patients. Genes included in this study were ESR1, EGFR, FGFR1, ADAM9, IKBKB, PRDM14, MTDH, MYC, CCND1, EMSY, CDH1, TRAF4, CPD, MED1, HER2, CDC6, TOP2A, MAPT, BIRC5, CCNE1 and AURKA.There were no significant differences in copy number for the 21 genes between DCIS and adjacent IDC. Low/intermediate-grade DCIS showed on average 6 gains/amplifications versus 8 in high-grade DCIS (p=0.158). Furthermore, alterations of AURKA and CCNE1 were exclusively found in high-grade DCIS, and HER2, PRDM14 and EMSY amplification was more frequent in high-grade DCIS than in low/intermediate-grade DCIS. In contrast, the average number of alterations in low/intermediate and high-grade IDC was similar, and although EGFR alterations were exclusively found in high-grade IDC compared to low/intermediate-grade IDC, there were generally fewer differences between low/intermediate-grade and high-grade IDC than between low/intermediate-grade and high-grade DCIS.In conclusion, there were no significant differences in copy number for 21 breast cancer related genes between DCIS and adjacent IDC, indicating that DCIS is genetically as advanced as its invasive counterpart. However, high-grade DCIS showed more copy number changes than low/intermediate-grade DCIS with specifically involved genes, supporting a model in which different histological grades of DCIS are associated with distinct genomic changes that progress to IDC in different routes. These high-grade DCIS specific genes may be potential targets for treatment and/or predict progression.
Highlights
The most widely held concept regarding the development of human breast cancer suggests that breast cancer progression is a multistep process that manifests itself as a sequence of pathologically defined stages with ductal carcinoma in situ (DCIS) as final pre-invasive stage before progression to invasive ductal carcinoma (IDC)
BIRC5, TOP2A, CCND1 and MED1 (PPARBP) gain/amplification seemed to be more prevalent in DCIS than IDC, overall, there were no significant differences between both components
We found three genes showing frequent (>5%) loss: FGFR1, CDH1 and MAPT, with no significant differences between DCIS and IDC
Summary
The most widely held concept regarding the development of human breast cancer suggests that breast cancer progression is a multistep process that manifests itself as a sequence of pathologically defined stages with ductal carcinoma in situ (DCIS) as final pre-invasive stage before progression to invasive ductal carcinoma (IDC). DCIS is a clonal epithelial proliferation that does not breech the basement membrane. IDC, on the other hand, is an abnormal proliferation of breast epithelial cells that infiltrates through the basement membrane into the surrounding stroma. The proportion of patients diagnosed with DCIS, and with a mixture of DCIS and IDC, is increasing as screening mammography becomes more common. DCIS accounts for approximately 20% of mammographically detected breast cancers.
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