Immune microenvironment as a prognostic marker of recurrence following breast conserving surgery for DCIS
Association of Breast Surgery ePoster Library. Dave R. 05/13/19; 257185; P143
Mr. Rajiv Dave
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P143
Topic: Recurrent disease
Introduction: The progression from ductal carcinoma in-situ (DCIS) to invasive disease remains poorly understood. Various biological processes have been considered, including the role of tumour infiltrating lymphocytes (TILs). Methods High-resolution APERIO digital histology slides were reviewed from a cohort of 423 patients with DCIS, with no microinvasion, treated with breast conserving surgery (BCS). StromalTILs were assessed manually using digital images, applying the International Working Group Recommendations for TILs assessment. Inter-observer variation was assessed. Results: The mean follow-up period in this cohort was 119 months (5.97 - 262.93). There were 109/423 patients with recurrence or contralateral disease on follow-up; 90 (82.6%) ipsilateral recurrence and 19 (17.4%) contralateral breast disease. Whilst 51 (46.8%) were DCIS recurrences, 53 (48.6%) were IDC recurrences, and 5 (4.6%) were ILC.There was an ‘excellent' inter-observer agreement in scoring of TILS, with intra-class coefficient of 0.831. There was no statistically significant difference in ipsilateral recurrence based on TILs density (p=0.591). On categorising TILs density as sparse (£5%) or dense (>5%), there was a non-significant trend towards increased ipsilateral recurrence with dense TILs (19.7% vs 23.2%, p=0.226), particularly evident in low-grade DCIS (15.9% vs 27.3%, p=0.315), and not influenced by radiotherapy (8.3% vs 9.5%, p=0.565).ConclusionLittle is known about the immune milieu of DCIS or the evolution of the anti-tumour immune response during the progression from DCIS to invasive disease. In this study, no significant association was found between stromal TILs density and recurrence. Future work aims to determine associations between TILs sub-types in DCIS and recurrence.
Topic: Recurrent disease
Introduction: The progression from ductal carcinoma in-situ (DCIS) to invasive disease remains poorly understood. Various biological processes have been considered, including the role of tumour infiltrating lymphocytes (TILs). Methods High-resolution APERIO digital histology slides were reviewed from a cohort of 423 patients with DCIS, with no microinvasion, treated with breast conserving surgery (BCS). StromalTILs were assessed manually using digital images, applying the International Working Group Recommendations for TILs assessment. Inter-observer variation was assessed. Results: The mean follow-up period in this cohort was 119 months (5.97 - 262.93). There were 109/423 patients with recurrence or contralateral disease on follow-up; 90 (82.6%) ipsilateral recurrence and 19 (17.4%) contralateral breast disease. Whilst 51 (46.8%) were DCIS recurrences, 53 (48.6%) were IDC recurrences, and 5 (4.6%) were ILC.There was an ‘excellent' inter-observer agreement in scoring of TILS, with intra-class coefficient of 0.831. There was no statistically significant difference in ipsilateral recurrence based on TILs density (p=0.591). On categorising TILs density as sparse (£5%) or dense (>5%), there was a non-significant trend towards increased ipsilateral recurrence with dense TILs (19.7% vs 23.2%, p=0.226), particularly evident in low-grade DCIS (15.9% vs 27.3%, p=0.315), and not influenced by radiotherapy (8.3% vs 9.5%, p=0.565).ConclusionLittle is known about the immune milieu of DCIS or the evolution of the anti-tumour immune response during the progression from DCIS to invasive disease. In this study, no significant association was found between stromal TILs density and recurrence. Future work aims to determine associations between TILs sub-types in DCIS and recurrence.
P143
Topic: Recurrent disease
Introduction: The progression from ductal carcinoma in-situ (DCIS) to invasive disease remains poorly understood. Various biological processes have been considered, including the role of tumour infiltrating lymphocytes (TILs). Methods High-resolution APERIO digital histology slides were reviewed from a cohort of 423 patients with DCIS, with no microinvasion, treated with breast conserving surgery (BCS). StromalTILs were assessed manually using digital images, applying the International Working Group Recommendations for TILs assessment. Inter-observer variation was assessed. Results: The mean follow-up period in this cohort was 119 months (5.97 - 262.93). There were 109/423 patients with recurrence or contralateral disease on follow-up; 90 (82.6%) ipsilateral recurrence and 19 (17.4%) contralateral breast disease. Whilst 51 (46.8%) were DCIS recurrences, 53 (48.6%) were IDC recurrences, and 5 (4.6%) were ILC.There was an ‘excellent' inter-observer agreement in scoring of TILS, with intra-class coefficient of 0.831. There was no statistically significant difference in ipsilateral recurrence based on TILs density (p=0.591). On categorising TILs density as sparse (£5%) or dense (>5%), there was a non-significant trend towards increased ipsilateral recurrence with dense TILs (19.7% vs 23.2%, p=0.226), particularly evident in low-grade DCIS (15.9% vs 27.3%, p=0.315), and not influenced by radiotherapy (8.3% vs 9.5%, p=0.565).ConclusionLittle is known about the immune milieu of DCIS or the evolution of the anti-tumour immune response during the progression from DCIS to invasive disease. In this study, no significant association was found between stromal TILs density and recurrence. Future work aims to determine associations between TILs sub-types in DCIS and recurrence.
Topic: Recurrent disease
Introduction: The progression from ductal carcinoma in-situ (DCIS) to invasive disease remains poorly understood. Various biological processes have been considered, including the role of tumour infiltrating lymphocytes (TILs). Methods High-resolution APERIO digital histology slides were reviewed from a cohort of 423 patients with DCIS, with no microinvasion, treated with breast conserving surgery (BCS). StromalTILs were assessed manually using digital images, applying the International Working Group Recommendations for TILs assessment. Inter-observer variation was assessed. Results: The mean follow-up period in this cohort was 119 months (5.97 - 262.93). There were 109/423 patients with recurrence or contralateral disease on follow-up; 90 (82.6%) ipsilateral recurrence and 19 (17.4%) contralateral breast disease. Whilst 51 (46.8%) were DCIS recurrences, 53 (48.6%) were IDC recurrences, and 5 (4.6%) were ILC.There was an ‘excellent' inter-observer agreement in scoring of TILS, with intra-class coefficient of 0.831. There was no statistically significant difference in ipsilateral recurrence based on TILs density (p=0.591). On categorising TILs density as sparse (£5%) or dense (>5%), there was a non-significant trend towards increased ipsilateral recurrence with dense TILs (19.7% vs 23.2%, p=0.226), particularly evident in low-grade DCIS (15.9% vs 27.3%, p=0.315), and not influenced by radiotherapy (8.3% vs 9.5%, p=0.565).ConclusionLittle is known about the immune milieu of DCIS or the evolution of the anti-tumour immune response during the progression from DCIS to invasive disease. In this study, no significant association was found between stromal TILs density and recurrence. Future work aims to determine associations between TILs sub-types in DCIS and recurrence.
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