Molecular/histologic classification of DClS as predictors of recurrence & survival

在美国，每年有50,000多名妇女被诊断出患有非致命性乳腺癌 称为导管原位癌(DCIS)。当活检确诊为DCIS时，大多数女性都是 接受乳房部分切除和乳房放射治疗或选择全乳房切除作为避免辐射的手段 心理治疗。治疗DCIS的新方法建议手术切除和观察， 或不进行内分泌治疗，可能是小体积、低级别DCIS的一种替代方案。然而，作为一名将军， 根据规则，DCIS的潜在生物学才刚刚开始在治疗DCIS的背景下被考虑。一个 大量关于DCIS潜在分子改变的基础科学研究表明 有两条主要的进展途径构成了一种惰性和侵略性的DCIS形式。的目标是 这项提议是为了将关于存在于 基于一组受限的分子、免疫组织化学或 可以可靠地识别DCIS中低级别和高级别进展途径的形态特征。这 将促进部分预后良好的DCIS和DCIS女性的保守治疗策略 减少过度治疗惰性乳房疾病的潜在不良后果。

Every year, over 50,000 women in the United States are diagnosed with the non-lethal form of breast cancer known as ductal carcinoma in situ (DCIS). When a diagnosis of DCIS is confirmed on biopsy, most women are treated with partial mastectomy and breast irradiation or elect total mastectomy as a means to avoid radiation therapy. Newer approaches to treatment for DCIS have suggested that surgical excision and observation, with or without endocrine therapy, may be an alternative for small volume, low grade DCIS. However, as a general rule, the underlying biology of DCIS is just beginning to be considered in the context of treating DCIS. A substantial body of basic science regarding the underlying molecular alterations present in DCIS suggests there are two major pathways of progression constituting an indolent and aggressive form of DCIS. The goal of this proposal Is to translate the research data on the numerous molecular genetic abnormalities present In DCIS into a pathology classification algorithm based on a restricted set of molecular, immunohistochemical, or morphologic features that will reliably Identify low grade and high grade progression pathways in DCIS. This would promote conservative treatment strategies for a subset of women with favorable prognosis DCIS and reduce the potential unfavorable consequences of over treating indolent breast disease.