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

每年，美国有超过50，000名妇女被诊断患有非致命形式的乳腺癌 称为导管原位癌（DCIS）。当活检确诊DCIS时，大多数女性 接受部分乳房切除术和乳房放疗或选择全乳房切除术作为避免放疗的手段 疗法较新的DCIS治疗方法表明，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的替代方案。作为一名将军， 在治疗DCIS的背景下，DCIS的潜在生物学才刚刚开始被考虑。一 关于DCIS中存在的潜在分子改变的大量基础科学表明， 有两种主要的进展途径构成了惰性和侵袭性形式的DCIS。的目标 这项建议是将目前存在的大量分子遗传异常的研究数据转化为 根据一组有限的分子、免疫组织化学或 形态学特征将可靠地识别DCIS中的低级别和高级别进展途径。这 将促进保守治疗策略的一个子集的妇女与良好的预后DCIS， 减少过度治疗惰性乳腺疾病的潜在不利后果。

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.