Shahla Masood
University of Florida College of Medicine-Jacksonville, USA
Title: Why the Term of “Low Grade Ductal Carcinoma In situ†should be changed to “Borderline Breast Diseaseâ€: Diagnostic and Clinical Implications
Biography
Biography: Shahla Masood
Abstract
During the last several years, increased public awareness, advances in breast imaging and enhanced screening programs have ledrnto early breast cancer detection and attention to cancer prevention. The numbers of image-detected biopsies have increasedrnand pathologists are expected to provide more information with smaller tissue samples. These biopsies have resulted in detectionrnof increasing numbers of high-risk proliferative breast disease and in situ cancers. The general hypothesis is that some forms ofrnbreast cancers may arise from established forms of ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) andrnpossibly from more common forms of ductal hyperplasia. However, this is an oversimplification of a very complex process, givenrnthe fact that the majority of breast cancers appears to arise de-novo or from a yet unknown precursor lesion. Currently, ADHrnand DCIS are considered as morphologic risk factors and precursor lesions for breast cancer. However, morphologic distinctionrnbetween these two entities has remained a real issue that continues to lead to overdiagnoses and overtreatment. Aside fromrnmorphologic similarities between ADH and low grade DCIS, biomarker studies and molecular genetic testing’s have shown thatrnmorphologic overlaps are reflected at the molecular levels and raise questions about the validity of separating these two entities. Itrnis hoped that as we better understand the genetic basis of these entities in relation to ultimate patient outcome, the suggested usernof the term of “Borderline Breast Disease†can minimize the number of patients who are subject to over treatment.