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Erschienen in: Current Breast Cancer Reports 3/2019

16.07.2019 | Translational Research (RL Aft, Section Editor)

How Did We Get There? The Progression from Ductal Carcinoma In Situ to Invasive Ductal Carcinoma

verfasst von: Kimberly Dessources, Ana Paula Martins Sebastiao, Fresia Pareja, Britta Weigelt, Jorge S. Reis-Filho

Erschienen in: Current Breast Cancer Reports | Ausgabe 3/2019

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Abstract

Purpose of Review

Ductal carcinoma in situ (DCIS) is a non-obligate precursor of invasive breast cancer. Despite numerous studies investigating the progression from in situ to invasive disease, there is still controversy as to the mechanisms by which a DCIS comes to become an invasive cancer. Here, we reviewed the state-of-the-art of the pathologic and molecular characterization of DCIS.

Recent Findings

DCIS displays intra-lesion genetic heterogeneity. Single-cell sequencing studies have demonstrated that progression from DCIS to invasive breast cancer is a complex phenomenon, which can vary from lesion to lesion. While in some DCIS, multiple clones have the ability to invade, in others, clonal selection likely takes place.

Summary

The fact that DCIS displays intra-lesion genetic heterogeneity and that progression varies from patient to patient poses formidable challenges for the development of biomarkers to define the risk of progression to invasive breast cancer.
Literatur
1.
Zurück zum Zitat Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ. WHO classification of tumors of the breast. 4th Edition ed. IARC Press; 2012. Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ. WHO classification of tumors of the breast. 4th Edition ed. IARC Press; 2012.
3.
Zurück zum Zitat • Hernandez L, Wilkerson PM, Lambros MB, Campion-Flora A, Rodrigues DN, Gauthier A, et al. Genomic and mutational profiling of ductal carcinomas in situ and matched adjacent invasive breast cancers reveals intra-tumour genetic heterogeneity and clonal selection. J Pathol. 2012;227(1):42–52. https://doi.org/10.1002/path.3990. They demonstrate that some DCIS and invasive breast carcinomas are composed of mosaics of neoplastic cells that harbor genetic alterations in addition to the founder genetic events, and the selection of populations with specific genomic alterations takes place in the progression from DCIS to invasive breast cancer. CrossRefPubMedPubMedCentral • Hernandez L, Wilkerson PM, Lambros MB, Campion-Flora A, Rodrigues DN, Gauthier A, et al. Genomic and mutational profiling of ductal carcinomas in situ and matched adjacent invasive breast cancers reveals intra-tumour genetic heterogeneity and clonal selection. J Pathol. 2012;227(1):42–52. https://​doi.​org/​10.​1002/​path.​3990. They demonstrate that some DCIS and invasive breast carcinomas are composed of mosaics of neoplastic cells that harbor genetic alterations in addition to the founder genetic events, and the selection of populations with specific genomic alterations takes place in the progression from DCIS to invasive breast cancer. CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat •• Martelotto LG, Baslan T, Kendall J, Geyer FC, Burke KA, Spraggon L, et al. Whole-genome single-cell copy number profiling from formalin-fixed paraffin-embedded samples. Nat Med. 2017;23(3):376–85. https://doi.org/10.1038/nm.4279. Applying single-cell sequencing to FFPE tumor material, they studied the progression from in situ to invasive breast cancer, which revealed that DCIS display intra-tumor genetic heterogeneity at diagnosis and that these lesions may progress to invasive breast cancer through a variety of evolutionary processes. •• Martelotto LG, Baslan T, Kendall J, Geyer FC, Burke KA, Spraggon L, et al. Whole-genome single-cell copy number profiling from formalin-fixed paraffin-embedded samples. Nat Med. 2017;23(3):376–85. https://​doi.​org/​10.​1038/​nm.​4279. Applying single-cell sequencing to FFPE tumor material, they studied the progression from in situ to invasive breast cancer, which revealed that DCIS display intra-tumor genetic heterogeneity at diagnosis and that these lesions may progress to invasive breast cancer through a variety of evolutionary processes.
7.
Zurück zum Zitat •• Casasent AK, Schalck A, Gao R, Sei E, Long A, Pangburn W, et al. Multiclonal Invasion in Breast Tumors Identified by Topographic Single Cell Sequencing. Cell. 2018;172(1–2):205–17.e12. https://doi.org/10.1016/j.cell.2017.12.007. The authors developed a spatially resolved single-cell genome sequencing method. Studying DCIS-IDC, genomic evolution was reported to occur in the DCIS, and invasion was found to entail the co-migration of multiple clones into the adjacent tissues. •• Casasent AK, Schalck A, Gao R, Sei E, Long A, Pangburn W, et al. Multiclonal Invasion in Breast Tumors Identified by Topographic Single Cell Sequencing. Cell. 2018;172(1–2):205–17.e12. https://​doi.​org/​10.​1016/​j.​cell.​2017.​12.​007. The authors developed a spatially resolved single-cell genome sequencing method. Studying DCIS-IDC, genomic evolution was reported to occur in the DCIS, and invasion was found to entail the co-migration of multiple clones into the adjacent tissues.
8.
Zurück zum Zitat Allegra CJ, Aberle DR, Ganschow P, Hahn SM, Lee CN, Millon-Underwood S, et al. National Institutes of Health state-of-the-science conference statement: diagnosis and Management of Ductal Carcinoma in Situ September 22-24, 2009. J Natl Cancer Inst. 2010;102(3):161–9. https://doi.org/10.1093/jnci/djp485.CrossRefPubMed Allegra CJ, Aberle DR, Ganschow P, Hahn SM, Lee CN, Millon-Underwood S, et al. National Institutes of Health state-of-the-science conference statement: diagnosis and Management of Ductal Carcinoma in Situ September 22-24, 2009. J Natl Cancer Inst. 2010;102(3):161–9. https://​doi.​org/​10.​1093/​jnci/​djp485.CrossRefPubMed
9.
Zurück zum Zitat Wellings SR, Jensen HM. On the origin and progression of ductal carcinoma in the human breast. J Natl Cancer Inst. 1973;50(5):1111–8.CrossRefPubMed Wellings SR, Jensen HM. On the origin and progression of ductal carcinoma in the human breast. J Natl Cancer Inst. 1973;50(5):1111–8.CrossRefPubMed
11.
Zurück zum Zitat Page DL, Dupont WD, Rogers LW, Jensen RA, Schuyler PA. Continued local recurrence of carcinoma 15-25 years after a diagnosis of low grade ductal carcinoma in situ of the breast treated only by biopsy. Cancer. 1995;76(7):1197–200.CrossRefPubMed Page DL, Dupont WD, Rogers LW, Jensen RA, Schuyler PA. Continued local recurrence of carcinoma 15-25 years after a diagnosis of low grade ductal carcinoma in situ of the breast treated only by biopsy. Cancer. 1995;76(7):1197–200.CrossRefPubMed
14.
Zurück zum Zitat Hanby AM. The pathology of breast cancer and the role of the histopathology laboratory. Clin Oncol (R Coll Radiol). 2005;17(4):234–9.CrossRef Hanby AM. The pathology of breast cancer and the role of the histopathology laboratory. Clin Oncol (R Coll Radiol). 2005;17(4):234–9.CrossRef
21.
Zurück zum Zitat Fisher ER, Dignam J, Tan-Chiu E, Costantino J, Fisher B, Paik S, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) eight-year update of protocol B-17: intraductal carcinoma. Cancer. 1999;86(3):429–38.CrossRefPubMed Fisher ER, Dignam J, Tan-Chiu E, Costantino J, Fisher B, Paik S, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) eight-year update of protocol B-17: intraductal carcinoma. Cancer. 1999;86(3):429–38.CrossRefPubMed
22.
Zurück zum Zitat Fisher B, Land S, Mamounas E, Dignam J, Fisher ER, Wolmark N. Prevention of invasive breast cancer in women with ductal carcinoma in situ: an update of the National Surgical Adjuvant Breast and bowel project experience. Semin Oncol. 2001;28(4):400–18.CrossRefPubMed Fisher B, Land S, Mamounas E, Dignam J, Fisher ER, Wolmark N. Prevention of invasive breast cancer in women with ductal carcinoma in situ: an update of the National Surgical Adjuvant Breast and bowel project experience. Semin Oncol. 2001;28(4):400–18.CrossRefPubMed
23.
Zurück zum Zitat Bijker N, Meijnen P, Peterse JL, Bogaerts J, Van Hoorebeeck I, Julien JP, et al. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phase III trial 10853--a study by the EORTC breast Cancer cooperative group and EORTC radiotherapy group. J Clin Oncol. 2006;24(21):3381–7. https://doi.org/10.1200/JCO.2006.06.1366.CrossRefPubMed Bijker N, Meijnen P, Peterse JL, Bogaerts J, Van Hoorebeeck I, Julien JP, et al. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phase III trial 10853--a study by the EORTC breast Cancer cooperative group and EORTC radiotherapy group. J Clin Oncol. 2006;24(21):3381–7. https://​doi.​org/​10.​1200/​JCO.​2006.​06.​1366.CrossRefPubMed
28.
Zurück zum Zitat Liang K, Lu Y, Jin W, Ang KK, Milas L, Fan Z. Sensitization of breast cancer cells to radiation by trastuzumab. Mol Cancer Ther. 2003;2(11):1113–20.PubMed Liang K, Lu Y, Jin W, Ang KK, Milas L, Fan Z. Sensitization of breast cancer cells to radiation by trastuzumab. Mol Cancer Ther. 2003;2(11):1113–20.PubMed
35.
Zurück zum Zitat •• Doebar SC, Krol NM, van Marion R, Brouwer RWW, van Ijcken WFJ, Martens JM, et al. Progression of ductal carcinoma in situ to invasive breast cancer: comparative genomic sequencing. Virchows Arch. 2018;474(2):247–51. https://doi.org/10.1007/s00428-018-2463-5. The authors found a high genomic concordance between synchronous DCIS and invasive breast cancers. The proportion of tumor cells harboring shared mutations between the DCIS and IDC was higher in the invasive component in a subset of patients. Their findings support the notion that progression of DCIS to invasive carcinoma could be driven by clonal selection. •• Doebar SC, Krol NM, van Marion R, Brouwer RWW, van Ijcken WFJ, Martens JM, et al. Progression of ductal carcinoma in situ to invasive breast cancer: comparative genomic sequencing. Virchows Arch. 2018;474(2):247–51. https://​doi.​org/​10.​1007/​s00428-018-2463-5. The authors found a high genomic concordance between synchronous DCIS and invasive breast cancers. The proportion of tumor cells harboring shared mutations between the DCIS and IDC was higher in the invasive component in a subset of patients. Their findings support the notion that progression of DCIS to invasive carcinoma could be driven by clonal selection.
36.
Zurück zum Zitat •• Pang JB, Savas P, Fellowes AP, Mir Arnau G, Kader T, Vedururu R, et al. Breast ductal carcinoma in situ carry mutational driver events representative of invasive breast cancer. Mod Pathol. 2017;30(7):952–63. https://doi.org/10.1038/modpathol.2017.21. GATA3 mutations in DCIS were found to be a marker of less aggressive behavior. In contrast, TP53 mutations were associated with adverse tumor characteristics. •• Pang JB, Savas P, Fellowes AP, Mir Arnau G, Kader T, Vedururu R, et al. Breast ductal carcinoma in situ carry mutational driver events representative of invasive breast cancer. Mod Pathol. 2017;30(7):952–63. https://​doi.​org/​10.​1038/​modpathol.​2017.​21. GATA3 mutations in DCIS were found to be a marker of less aggressive behavior. In contrast, TP53 mutations were associated with adverse tumor characteristics.
39.
Zurück zum Zitat Pan A, Zhou Y, Mu K, Liu Y, Sun F, Li P, et al. Detection of gene copy number alterations in DCIS and invasive breast cancer by QM-FISH. Am J Transl Res. 2016;8(11):4994–5004.PubMedPubMedCentral Pan A, Zhou Y, Mu K, Liu Y, Sun F, Li P, et al. Detection of gene copy number alterations in DCIS and invasive breast cancer by QM-FISH. Am J Transl Res. 2016;8(11):4994–5004.PubMedPubMedCentral
40.
Zurück zum Zitat • Sakr RA, Weigelt B, Chandarlapaty S, Andrade VP, Guerini-Rocco E, Giri D, et al. PI3K pathway activation in high-grade ductal carcinoma in situ--implications for progression to invasive breast carcinoma. Clin Cancer Res. 2014;20(9):2326–37. https://doi.org/10.1158/1078-0432.CCR-13-2267. The authors found genetic alterations affecting the PI3K pathway in a subset of pure DCIS and DCIS adjacent to invasive breast cancer. A receptor subtype-matched comparison of pure DCIS and DCIS adjacent to invasive breast cancer revealed that PIK3CA hotspot mutations and pAKT expression were significantly more prevalent in ER-positive /HER2-negative DCIS adjacent to invasive carcinoma. They concluded that molecular alterations affecting the PI3K pathway may play a role in the progression from high-grade DCIS to invasive breast cancer in a subset of ER-positive/ HER2-negative lesions. • Sakr RA, Weigelt B, Chandarlapaty S, Andrade VP, Guerini-Rocco E, Giri D, et al. PI3K pathway activation in high-grade ductal carcinoma in situ--implications for progression to invasive breast carcinoma. Clin Cancer Res. 2014;20(9):2326–37. https://​doi.​org/​10.​1158/​1078-0432.​CCR-13-2267. The authors found genetic alterations affecting the PI3K pathway in a subset of pure DCIS and DCIS adjacent to invasive breast cancer. A receptor subtype-matched comparison of pure DCIS and DCIS adjacent to invasive breast cancer revealed that PIK3CA hotspot mutations and pAKT expression were significantly more prevalent in ER-positive /HER2-negative DCIS adjacent to invasive carcinoma. They concluded that molecular alterations affecting the PI3K pathway may play a role in the progression from high-grade DCIS to invasive breast cancer in a subset of ER-positive/ HER2-negative lesions.
43.
Zurück zum Zitat Rane SU, Mirza H, Grigoriadis A, Pinder SE. Selection and evolution in the genomic landscape of copy number alterations in ductal carcinoma in situ (DCIS) and its progression to invasive carcinoma of ductal/no special type: a meta-analysis. Breast Cancer Res Treat. 2015;153(1):101–21. https://doi.org/10.1007/s10549-015-3509-x.CrossRefPubMed Rane SU, Mirza H, Grigoriadis A, Pinder SE. Selection and evolution in the genomic landscape of copy number alterations in ductal carcinoma in situ (DCIS) and its progression to invasive carcinoma of ductal/no special type: a meta-analysis. Breast Cancer Res Treat. 2015;153(1):101–21. https://​doi.​org/​10.​1007/​s10549-015-3509-x.CrossRefPubMed
57.
Zurück zum Zitat Gudjonsson T, Rønnov-Jessen L, Villadsen R, Rank F, Bissell MJ, Petersen OW. Normal and tumor-derived myoepithelial cells differ in their ability to interact with luminal breast epithelial cells for polarity and basement membrane deposition. J Cell Sci. 2002;115(Pt 1:39–50.PubMed Gudjonsson T, Rønnov-Jessen L, Villadsen R, Rank F, Bissell MJ, Petersen OW. Normal and tumor-derived myoepithelial cells differ in their ability to interact with luminal breast epithelial cells for polarity and basement membrane deposition. J Cell Sci. 2002;115(Pt 1:39–50.PubMed
66.
Zurück zum Zitat Kristensen VN, Vaske CJ, Ursini-Siegel J, Van Loo P, Nordgard SH, Sachidanandam R, et al. Integrated molecular profiles of invasive breast tumors and ductal carcinoma in situ (DCIS) reveal differential vascular and interleukin signaling. Proc Natl Acad Sci U S A. 2012;109(8):2802–7. https://doi.org/10.1073/pnas.1108781108.CrossRefPubMed Kristensen VN, Vaske CJ, Ursini-Siegel J, Van Loo P, Nordgard SH, Sachidanandam R, et al. Integrated molecular profiles of invasive breast tumors and ductal carcinoma in situ (DCIS) reveal differential vascular and interleukin signaling. Proc Natl Acad Sci U S A. 2012;109(8):2802–7. https://​doi.​org/​10.​1073/​pnas.​1108781108.CrossRefPubMed
Metadaten
Titel
How Did We Get There? The Progression from Ductal Carcinoma In Situ to Invasive Ductal Carcinoma
verfasst von
Kimberly Dessources
Ana Paula Martins Sebastiao
Fresia Pareja
Britta Weigelt
Jorge S. Reis-Filho
Publikationsdatum
16.07.2019
Verlag
Springer US
Erschienen in
Current Breast Cancer Reports / Ausgabe 3/2019
Print ISSN: 1943-4588
Elektronische ISSN: 1943-4596
DOI
https://doi.org/10.1007/s12609-019-00318-2

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