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Related Experiment Videos

Intermediate histological effect markers for breast cancer.

A B Miller1, A M Borges

  • 1Division of Clinical Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany.

IARC Scientific Publications
|February 28, 2001
PubMed
Summary

Ductal carcinoma in situ (DCIS) may not be a reliable marker for breast cancer chemoprevention research. Current evidence suggests DCIS detection and treatment do not impact future breast cancer incidence.

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Area of Science:

  • Oncology
  • Preventive Medicine
  • Biomarker Research

Background:

  • Ductal carcinoma in situ (DCIS) has been considered a precursor to invasive breast cancer.
  • Historically, evidence on DCIS natural history predates widespread mammographic screening.
  • Current chemoprevention trials involve women under mammographic surveillance.

Purpose of the Study:

  • To review the evidence supporting DCIS as an intermediate effect marker in breast cancer chemoprevention.
  • To assess the applicability of historical DCIS data in the era of mammographic screening.
  • To evaluate the sufficiency of DCIS as a sole intermediate endpoint in chemoprevention research.

Main Methods:

  • Literature review of studies on DCIS natural history.
  • Analysis of data from breast screening trials regarding DCIS detection and treatment impact.

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  • Examination of biomarker expression similarities between DCIS and invasive breast cancer.

    • Main Results:

    • Evidence for DCIS as an obligate precursor is largely from the pre-mammography era.
    • Long-term breast screening trial data (over a decade) indicate no impact of DCIS detection/treatment on subsequent breast cancer incidence.
    • While some biomarkers are similarly expressed in DCIS and invasive cancer, this is not universally sufficient.

    Conclusions:

    • The role of DCIS as a reliable intermediate effect marker in breast cancer chemoprevention is questionable.
    • Mammographic surveillance may alter the natural history and clinical relevance of DCIS.
    • Further research is needed to validate alternative or supplementary intermediate endpoints for chemoprevention trials.