Biological response to hormonal manipulation in oestrogen receptor positive ductal carcinoma in situ of the breast

被引:16
作者
Boland, GP
Mckeown, A
Chan, KC
Prasad, R
Knox, WF
Bundred, NJ
机构
[1] Univ S Manchester Hosp, Dept Surg, Manchester M20 8LR, Lancs, England
[2] Univ S Manchester Hosp, Dept Pathol, Manchester M20 8LR, Lancs, England
关键词
DCIS; HRT; response; tamoxifen; recurrence; breast;
D O I
10.1038/sj.bjc.6601013
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Adjuvant antioestrogen therapy with tamoxifen is recommended for all women following breast-conserving surgery for ductal carcinoma in situ ( DCIS) to reduce local recurrence, despite 50% of lesions being oestrogen receptor ( OR) negative. We have investigated the response to hormone manipulation in DCIS by studying changes in epithelial proliferation and progesterone receptor ( PR) expression as surrogate molecular markers of treatment effects in DCIS of known OR status. Women were identified who had undergone diagnostic core biopsy followed by surgery for DCIS 14 - 41 days later. Ki67 ( a measure of epithelial cell proliferation) and PR expression were determined by immunohistochemistry on paired paraffin sections of the core biopsy and operative specimens for each patient, with OR and HER-2 measured on the operative specimen. Women were divided into three groups according to whether they had changed hormone therapy ( stopped hormone replacement therapy (HRT), group 1), continued taking HRT ( group 2) or were not taking HRT ( group 3) between core biopsy and surgery. In OR-positive ( but not in OR-negative) DCIS after oestrogen withdrawal ( group 1), a fall in the mean cell proliferation (P<0.01) was observed. A fall in PR expression between core biopsy and surgery was also seen in this group ( P = 0.02). No change in either mean cell proliferation or PR expression was seen in the other two groups in OR-positive or - negative DCIS. The fall in proliferation and PR expression occurred regardless of HER-2 status. In conclusion, a biological response to hormone manipulation is only seen in OR-positive DCIS tumours. Any clinical value of antioestrogen therapy is likely to be restricted to this group.
引用
收藏
页码:277 / 283
页数:7
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