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Retinoblastoma, PTEN may predict DCIS progression to invasive breast cancer
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Loss of retinoblastoma immunoreactivity was associated with a nearly threefold risk for an ipsilateral breast event in women with ductal carcinoma in situ, according to study results.
Researchers conducted the study to help identify markers that could determine which cases of ductal carcinoma in situ (DCIS) were likely to progress to invasive breast cancer.
The researchers examined findings from 236 DCIS patients treated with breast-conserving surgery who had long-term follow-up data available. They studied whether retinoblastoma and phosphatase and tensin homolog (PTEN) were associated with a risk for any ipsilateral breast event or progression to invasive disease.
The investigators observed a strong association between loss of retinoblastoma immunoreactivity and risk for an ipsilateral breast event (HR=2.64; 95% CI, 1.64-4.25). Retinoblastoma also was strongly linked to recurrence of invasive disease (HR=4.66; 95% CI, 2.19-9.93).
Multivariate analysis results indicated that the predictive power of retinoblastoma loss remained statistically significant when other factors were taken into account.
Although PTEN loss occurred frequently in DCIS, researchers observed no link between PTEN loss and recurrence or progression. However, patients with DCIS tumors who had deficiencies in both retinoblastoma and PTEN were at an increased risk for an ipsilateral breast event (HR=3.39; 95% CI, 1.92-5.99) and a recurrence of invasive disease (HR=6.1, 95% CI, 2.5-14.76).
Loss of retinoblastoma and PTEN affected proliferation, motility and invasive properties, according to a preclinical model of MCF10A cells.
Perspective
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Joseph R. Bertino, MD
More evidence that lack of retinoblastoma protein results in more “free” activating transcription E2Fs, and increased proliferation.
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