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BMC Cancer
Published in: BMC Cancer 1/2013

Open Access 01-12-2013 | Research article

Molecular subtypes in ductal carcinoma in situ of the breast and their relation to prognosis: a population-based cohort study

Authors: Wenjing Zhou, Karin Jirström, Rose-Marie Amini, Marie-Louise Fjällskog, Thomas Sollie, Henrik Lindman, Therese Sørlie, Carl Blomqvist, Fredrik Wärnberg

Published in: BMC Cancer | Issue 1/2013

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Abstract

Background

Different molecular subtypes of breast cancer have been identified based on gene expression profiling. Treatment suggestions based on an approximation of these subtypes by immunohistochemical criteria have been published by the St Gallen international expert consensus panel. Ductal carcinoma in situ (DCIS) can be classified into the same molecular subtypes. Our aim was to study the relation between these newly defined subtypes and prognosis in DCIS.

Methods

TMA including 458 women from a population-based cohort with DCIS diagnosed 1986–2004 was used. Stainings for ER, PR, HER2 and Ki67 were used to classify the surrogate molecular subtypes according to the St Gallen criteria from 2011. The associations with prognosis were examined using Kaplan-Meier analyses and Cox proportional hazards regression models.

Results

Surrogate molecular subtyping could be done in 381 cases. Mean follow up was 164 months. Of the classified DCIS 186 were Luminal A (48.8%), 33 Luminal B/HER2- (8.7%), 74 Luminal B/HER2+ (17.4%), 61 HER2+/ER- (16.0%) and 27 Triple Negative (7.1%). One hundred and two women had a local recurrence of which 58 were invasive. Twenty-two women had generalised disease, 8 without a prior local recurrence. We could not find a prognostic significance of the molecular subtypes other than a higher risk of developing breast cancer after more than 10 years of follow-up among women with a Triple Negative DCIS (OR 3.2; 95% CI 1.1-9.8).

Conclusions

The results from this large population-based cohort, with long-term follow up failed to demonstrate a prognostic value for the surrogate molecular subtyping of DCIS using the St Gallen criteria up to ten years after diagnosis. More than ten years after diagnosis Triple Negative DCIS had an elevated risk of recurrence.
Appendix
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Metadata
Title
Molecular subtypes in ductal carcinoma in situ of the breast and their relation to prognosis: a population-based cohort study
Authors
Wenjing Zhou
Karin Jirström
Rose-Marie Amini
Marie-Louise Fjällskog
Thomas Sollie
Henrik Lindman
Therese Sørlie
Carl Blomqvist
Fredrik Wärnberg
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2013
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-13-512

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