The Experts below are selected from a list of 222 Experts worldwide ranked by ideXlab platform

Carolyn M Kaelin - One of the best experts on this subject based on the ideXlab platform.

  • ductal Carcinoma in Situ of the breast
    The New England Journal of Medicine, 2004
    Co-Authors: Harold J Burstein, Kornelia Polyak, Julia S Wong, Susan Lester, Carolyn M Kaelin
    Abstract:

    Ductal Carcinoma in Situ of the breast (also called intraductal Carcinoma), a clonal proliferation of malignant-appearing cells within the mammary duct lumens without evidence of invasion beyond the epithelial basement membrane, is the precursor lesion of invasive breast cancer. in the past 20 years, concomitant with the wide use of screening mammography, its detected incidence has risen dramatically. Data from large cohort studies and randomized trials have emerged to guide treatment. This review summarizes progress in the understanding, pathogenesis, and treatment of ductal Carcinoma in Situ.

Lavinia P. Middleton - One of the best experts on this subject based on the ideXlab platform.

  • The Diagnosis of Pleomorphic Lobular Carcinoma in Situ Warrants Complete Excision with Negative Margins
    Current Breast Cancer Reports, 2012
    Co-Authors: Lavinia P. Middleton
    Abstract:

    Pleomorphic lobular Carcinoma in Situ (PLCIS) is a recently described variant of lobular Carcinoma in Situ. Although classic lobular Carcinoma in Situ (LCIS) is seen as a risk factor and non-obligate precursor for the development of invasive breast cancer, PLCIS is considered an even greater high-risk lesion. When patients are diagnosed with PLCIS on core biopsy, the recommendation is to perform an excisional biopsy of the affected area. Re-excision is not commonly recommended for patients with classic LCIS at or near a margin after breast conserving therapy, whereas excision with negative margins is recommended for patients with PLCIS. This review gives an overview of the biologic rationale for complete excision with negative margins for patients diagnosed with PLCIS, reviews historical data and clinical studies relevant to patients with PLCIS, and provides molecular rationale that supports treating patients with PLCIS more aggressively than patients with classic LCIS, and similar to intermediate-grade ductal Carcinoma in Situ (DCIS).

  • Lobular Carcinoma in Situ Diagnosed By Core Needle Biopsy: When Should It Be Excised?
    Modern Pathology, 2003
    Co-Authors: Lavinia P. Middleton, Shakeitha Grant, Tanya Stephens, Carol B Stelling, Nour Sneige, Aysegul A Sahin
    Abstract:

    Core needle biopsy is the preferred technique for evaluating breast masses and abnormal mammographic findings. The frequency of detection of noninvasive lobular lesions by core needle biopsy is increasing. Historically, the diagnosis of lobular Carcinoma in Situ has been considered a risk factor for the development of invasive Carcinoma, and treatment has consisted of careful clinical follow-up with or without chemopreventive therapeutic agents such as tamoxifen citrate. We retrospectively reviewed core needle biopsy material with the primary diagnoses of lobular Carcinoma in Situ , atypical lobular hyperplasia, and lobular neoplasia in conjunction with clinical and radiographic findings to make recommendations as to when excision may be merited. We searched our database for core needle biopsy cases with lobular Carcinoma in Situ , atypical lobular hyperplasia, and lobular neoplasia as the primary diagnosis. Microcalcifications had been sampled with a stereotactically guided, 11 G Mammotome biopsy device, and masses had been sampled with an ultrasound guided, 18 G core needle. Glass slides were reviewed and histological parameters assessed. Mammographic findings were reviewed, and clinical information was obtained from the medical record. When available, excisional biopsy material was reviewed. The 2337 breast core needle biopsies performed from January 1995 to December 2001 included 35 (1.5%) with classic lobular Carcinoma in Situ (14), lobular neoplasia (4), and atypical lobular hyperplasia (17) as the primary diagnosis. Twelve of these 35 cases (34%) had histological evidence of microcalcifications directly associated with the lobular Carcinoma in Situ , lobular neoplasia, atypical lobular hyperplasia. Radiologic review revealed 21 calcifications, 6 ultrasonographic masses, and 8 mammographic masses and/or architectural distortions. Excisional biopsy had been performed in 17 cases (49%). in six cases diagnosed as in Situ on core needle biopsy, excisional biopsy revealed invasive Carcinoma. All of these patients had radiographically detectable masses. Eleven cases had excisional biopsies that showed histology similar to that of the core needle biopsies. The most important predictor of invasive Carcinoma on excision was a synchronous mass lesion. Lobular Carcinoma in Situ involving adenosis and lobular Carcinoma in Situ with pagetoid spread on core needle biopsies did not show a histologically more aggressive lesion on excision and, therefore, may not require additional surgery. Histologically identified calcifications were associated with lobular lesions 34% of the time; however, their presence inside an in Situ lobular lesion did not portend worse pathology on re-excision and should not be a criterion for excision. Based on these findings, we recommend excisional biopsy of lobular Carcinoma in Situ , atypical lobular hyperplasia or lobular neoplasia only when it is associated with a synchronous mass lesion.

A D Baildam - One of the best experts on this subject based on the ideXlab platform.

  • mixed apocrine endocrine ductal Carcinoma in Situ of the breast coexistent with lobular Carcinoma in Situ
    Journal of Clinical Pathology, 2001
    Co-Authors: J D Coyne, P Dervan, L Barr, A D Baildam
    Abstract:

    An unusual mixed form of ductal Carcinoma in Situ (DCIS) of the breast is described, which exhibits a biphenotypic morphology encompassing a range of differential diagnostic DCIS subtypes. in adddition, immunophenotypic and ultrastructural studies demonstrate neuroendocrine and apocrine differentiation, raising questions regarding appropriate classification and biological behaviour. in two cases, coexistence of this mixed form of DCIS with lobular Carcinoma in Situ (LCIS) in the same duct lobular units is an additional unusual feature that might, at least in some cases, indicate a closer relation between them.

  • Mixed apocrine/endocrine ductal Carcinoma in Situ of the breast coexistent with lobular Carcinoma in Situ
    Journal of Clinical Pathology, 2001
    Co-Authors: J D Coyne, P Dervan, L Barr, A D Baildam
    Abstract:

    An unusual mixed form of ductal Carcinoma in Situ (DCIS) of the breast is described, which exhibits a biphenotypic morphology encompassing a range of differential diagnostic DCIS subtypes. in adddition, immunophenotypic and ultrastructural studies demonstrate neuroendocrine and apocrine differentiation, raising questions regarding appropriate classification and biological behaviour. in two cases, coexistence of this mixed form of DCIS with lobular Carcinoma in Situ (LCIS) in the same duct lobular units is an additional unusual feature that might, at least in some cases, indicate a closer relation between them.

Susan Fineberg - One of the best experts on this subject based on the ideXlab platform.

  • correlation of histopathologic features of ductal Carcinoma in Situ of the breast with the oncotype dx dcis score
    Modern Pathology, 2015
    Co-Authors: Adriana Knopfelmacher, Yungtai Lo, Nella Shapiro, Susan Fineberg
    Abstract:

    The Oncotype DX Breast Cancer Assay for ductal Carcinoma in Situ is used to determine local recurrence risk in patients with ductal Carcinoma in Situ. The results help select patients with low-risk ductal Carcinoma in Situ who could forgo radiation therapy after conservative surgery. The genes assessed include five proliferation genes, progesterone receptor (PR), and GSTM-1. Our objective was to determine if PR, mitotic counting, or any other pathologic feature of ductal Carcinoma in Situ could predict the Oncotype DX DCIS Score. We identified 46 cases of ductal Carcinoma in Situ with a Oncotype DX DCIS Score. in addition to information obtained from routine pathology, we counted mitotic figures in the ductal Carcinoma in Situ and noted presence of dense chronic inflammatory infiltrate surrounding ductal Carcinoma in Situ. We found that PR ≥90% (P=0.004), mitotic count ≤1 (P=0.045), estrogen receptor ≥90% (P=0.046), and low nuclear grade (P 1 mitotic figure, and/or presence of dense chronic inflammation around ductal Carcinoma in Situ (100% specificity). Our study suggests using a combination of PR (≥90% vs negative) with mitotic count in ductal Carcinoma in Situ (≤1 vs >1) and dense chronic inflammation around ductal Carcinoma in Situ one could predict the Oncotype DX DCIS score. Mitotic counting and evaluation of immune response might provide prognostic information in ductal Carcinoma in Situ.

Harold J Burstein - One of the best experts on this subject based on the ideXlab platform.

  • ductal Carcinoma in Situ of the breast
    The New England Journal of Medicine, 2004
    Co-Authors: Harold J Burstein, Kornelia Polyak, Julia S Wong, Susan Lester, Carolyn M Kaelin
    Abstract:

    Ductal Carcinoma in Situ of the breast (also called intraductal Carcinoma), a clonal proliferation of malignant-appearing cells within the mammary duct lumens without evidence of invasion beyond the epithelial basement membrane, is the precursor lesion of invasive breast cancer. in the past 20 years, concomitant with the wide use of screening mammography, its detected incidence has risen dramatically. Data from large cohort studies and randomized trials have emerged to guide treatment. This review summarizes progress in the understanding, pathogenesis, and treatment of ductal Carcinoma in Situ.