December 10, 2010 (San Antonio, Texas) — "Nobody knows whether patients with HER2-positive ductal carcinoma in situ (DCIS) have increased local recurrence of disease," said Lia Halasz, MD, a radiation oncology resident at Dana-Farber/Brigham and Women's Cancer Center in Boston, Massachusetts.
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So, with the help of some colleagues, Dr. Halasz went in search of an answer.
Fortunately, the Dana-Farber/Brigham and Women's Cancer Center has, for the past 7 years, routinely looked at the HER2 status of pure DCIS patients, she said. "That's not standard practice in the United States," she told Medscape Medical News here at the 33rd Annual San Antonio Breast Cancer Symposium, where her study on the subject was presented as a poster.
The investigators reviewed the records of 246 DCIS patients at their center who had undergone breast-conserving surgery and adjuvant radiation from 2001 to 2007. The patients received tamoxifen on the basis of their hormone-receptor status.
Dr. Halasz acknowledged that the use of radiation therapy in DCIS patients is a matter of controversy. However, that's what they do at Dana-Farber/Brigham and Women's Cancer Center. "In previous research, we have been unable to identify a group of DCIS patients not needing radiation therapy," she said.
Of the 246 DCIS patients, 163 had their HER2 status evaluated; 33 (20%) were HER2-positive.
The researchers discovered that HER2-positive DCIS gives clinicians reason to be concerned about possible local recurrence. This subtype of DCIS was, in the study, significantly associated with more comedo necrosis, grade 3 disease; more estrogen- and progesterone-receptor-negative status; and "more extensive DCIS," she said.
As it turned out, all of the patients in the study, including those with HER2-positive disease, were recurrence free at a median follow-up of 58 months.
With no recurrences to analyze, Dr. Halasz and colleagues could not say whether HER2 status puts patients at more or less risk for recurrence.
"It's still an interesting question — whether HER2 status influences outcome in DCIS," she said. "It doesn't seem to influence recurrence when patients are treated with radiation and surgery," she concluded.
The authors have disclosed no relevant financial relationships.
33rd Annual San Antonio Breast Cancer Symposium (SABCS): Abstract P1-15-07. Presented December 9, 2010.
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Cite this: Does HER2 Status Influence Outcomes in DCIS? - Medscape - Dec 10, 2010.
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