In situ carcinoma - can we predict which patient will come back with a recurrence?

The frequency of in situ carcinomas has been rising since the introduction of mammographic screening. The management of patients with preinvasive disease remains difficult due to our lack of ability to accurately predict which patients will recur and progress to invasive carcinoma. Although some factors, such as lesion size and extent of margin clearance, are strong predictors of recurrence, many patients are still under- or overtreated. In this issue of Cancer Cell, Gauthier and colleagues suggest that abrogated response to cell stress measured by analysis of p16 and the proliferation marker Ki67 accurately predicts recurrence in ductal carcinoma in situ.