Regular Article

British Journal of Cancer (2001) 84, 539–544. doi:10.1054/bjoc.2000.1618 www.bjcancer.com
Published online 13 February 2001

Histological type and marker expression of the primary tumour compared with its local recurrence after breast-conserving therapy for ductal carcinoma in situ

N Bijker1, J L Peterse1, L Duchateau2, E C Robanus-Maandag1,3, C A J Bosch1,3, C Duval4, S Pilotti5 and M J van de Vijver2

  1. 1Department of Pathology, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, CX, 1066, NL
  2. 2EORTC Data Center, Avenue E. Mounier 83, bte 11, Brussels, 1200, Belgium
  3. 3Division of Experimental Therapy, The Netherlands Cancer Institute, Plesmanlaan 121, Amsterdam, 1066 CX, NL
  4. 4Department of Pathology, Centre Henri Becquerel, 1 Rue d'Amiens, Rouen, 76038, France
  5. 5Department of Pathology, Istituto Nazionale dei Tumori, Via Venezian 1, Milan, 20133, Italy

Correspondence: MJ van de Vijver, (e-mail: mvijver@nki.nl)

Received 29 June 2000; Revised 6 November 2000; Accepted 8 November 2000.

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Abstract

We have investigated primary ductal carcinomas in situ (DCIS) of the breast and their local recurrences after breast-conserving therapy (BCT) for histological characteristics and marker expression. Patients who were randomized in the EORTC trial 10853 (wide local excision versus excision plus radiotherapy) and who developed a local recurrence were identified. Histology was reviewed for 116 cases; oestrogen and progesterone receptor status, and HER2/neu and p53 overexpression were assessed for 71 cases. Comparing the primary DCIS and the invasive or non-invasive recurrence, concordant histology was found in 62%, and identical marker expression in 63%. Although 11% of the recurrences developed at a distance from the primary DCIS, nearly all these showed the same histological and immunohistochemical profile. 5 patients developed well-differentiated DCIS or grade I invasive carcinoma after poorly differentiated DCIS. Although these recurrences occurred in the same quadrant as the primary DCIS, they may be considered as second primary tumours. Only 4 patients developed poorly differentiated DCIS or grade III invasive carcinoma after well differentiated DCIS. We conclude that in most cases the primary DCIS and its local recurrence are related histologically or by marker expression, suggesting that local recurrence usually reflects outgrowth of residual DCIS; progression of well differentiated DCIS towards poorly differentiated DCIS or grade III invasive carcinoma is a non-frequent event. © 2001 Cancer Research Campaign

Keywords:

ductal carcinoma in situ, breast-conserving therapy, local recurrence, histology, immunohistochemistry

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