Prognostic and predictive molecular markers in DCIS: a review

Sharon Nofech-Mozes¹, Jacqueline Spayne, Eileen Rakovitch

¹Department of Pathology, Sunnybrook and Women's College Health Sciences Center, Toronto, Ontario, Canada.

|October 8, 2005

Summary

Identifying biologic markers for ductal carcinoma in situ (DCIS) is crucial for predicting invasive recurrence. This review examines established and investigative markers to improve prognostic accuracy beyond the van Nuys Index.

Area of Science:

Oncology
Pathology
Biomarkers

Background:

Ductal carcinoma in situ (DCIS) accounts for 18% of screening mammography findings and is highly curable.
A subset of DCIS cases progress to invasive breast cancer, necessitating improved risk stratification.
Current treatment for DCIS is uniform due to unknown predictors of invasive recurrence.

Purpose of the Study:

To review biologic markers for their potential in predicting invasive recurrence in DCIS.
To evaluate established and investigative markers for prognostic accuracy.
To compare marker-based prognostication with the van Nuys Index.

Main Methods:

Comprehensive literature review of biologic markers in breast cancer and DCIS.
Analysis of marker expression and role in cell proliferation, cycle regulation, extracellular matrix, and angiogenesis.
Examination of studies assessing prognostic value for invasive recurrence.

Main Results:

Established markers (ER, PR, HER2/neu) are routinely used for treatment decisions.
Investigative markers related to proliferation, cell cycle, ECM degradation, and angiogenesis show potential.
Controversies exist regarding the prognostic value and interrelationships of these markers.

Conclusions:

Accurate prediction of invasive recurrence in DCIS requires further research into biologic markers.
Biomarker profiling may offer improved prognostic information over current methods.
Standardization and validation of prognostic factors are needed for clinical application.

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Main Results:

Conclusions:

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