Genes may help identify which cases of ductal carcinoma in situ are most likely to become invasive breast cancer.
The analysis of eight immune-system-related genes may make it easier for doctors to treat women with ductal carcinoma in situ (DCIS), which accounts for about one-quarter of all breast cancer diagnoses.
Those genes are MAGEA10, TNFAIP8, IL3RA1, TAGAP, CBLB, IFNA17, CCL2 and LRP1.
This discovery comes from a team led by Elena Guerini-Rocco, Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy. Guerini-Rocco and her colleagues studied 143 women with DCIS who underwent breast surgery. Of those women, 70 developed a breast tumor after surgery and 73 did not. Researchers also analyzed the expression of 395 immune-related genes in pure DCIS to see which ones were most closely associated with in situ and invasive relapses.
Researchers were able to study the correlation because the tumor immune microenvironment plays a role in the development, progression and treatment response of cancer.
The genes MAGEA10, IFNA17 and CBLB were the most expressed in DCIS cases that progressed to invasive cancer. The genes IL3RA1, TAGAP, TNFAIP8, CCL2 and LRP1 represented a lower risk of invasive cancer.
Also called intraductal carcinoma, or stage 0 breast cancer, DCIS occurs within the ducts of breast tissue. Rates for DCIS have increased 11-fold in the past decade. DCIS does not directly develop into metastatic cancer. But between 20% to 53% of cases become invasive breast cancer, which can then metastasize.
Even though DCIS cannot metastasize, it has the potential to progress in 20% to 53% of women, according to the study. If it does become an invasive cancer, it may spread to other parts of the body.
With no way to predict if DCIS will turn into an invasive cancer, physicians treat almost all DCIS patients as invasive cancer patients, which can lead to overtreatment, the
The identification of these genes may allow physicians to be more targeted with their treatments.
“This exploratory analysis of pure DCIS showed significant differences in immune-related gene expression profiles between women with and with no subsequent IBE, particularly as invasive IBE,” Guerini-Rocco writes in the study. “These results, after additional validation, could improve risk stratification and management of DCIS patients.”
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