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Prognostic significance of ductal carcinoma in situ coexisting with invasive ductal carcinoma: Biological behavior, immune response and survival outcomes

  • Authors:
    • Neslihan Koray Fedai
    • Ilgin Koc
    • Gozde Kavgaci
    • Meral Uner
    • Aysegul Uner
    • Sercan Aksoy
    • Neyran Kertmen
  • View Affiliations / Copyright

    Affiliations: Department of Internal Medicine, Hacettepe University, School of Medicine, Ankara 06230, Turkey, Department of Medical Oncology, Hacettepe University, School of Medicine, Ankara 06230, Turkey, Department of Pathology, Hacettepe University, School of Medicine, Ankara 06230, Turkey
    Copyright: © Fedai et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 1
    |
    Published online on: October 27, 2025
       https://doi.org/10.3892/mco.2025.2910
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Abstract

Biological differences exist between invasive ductal carcinoma (IDC) and IDC + ductal carcinoma in situ (DCIS) tumors including variations in tumor grade, hormone receptor status, human epidermal growth factor receptor 2 (HER2) expression, proliferative activity and molecular subtype. The present study evaluated the impact of the coexistence of IDC + DCIS on tumor microenvironment, tumor‑infiltrating lymphocytes (TILs), clinical and pathological features, prognosis and survival. A total of 165 patients with IDC and 404 with IDC + DCIS were enrolled and treated in the outpatient clinic, Hacettepe University Department of Medical Oncology (Ankara, Turkey) between January 2014 and July 2021. Compared with IDC, patients with IDC + DCIS were more likely to be hormone receptor‑positive and had a lower rate of mastectomy and Ki‑67 index (both P<0.05). The co‑existence of DCIS was associated with significantly improved overall survival (OS) and disease‑free survival (DFS) (both P<0.05). Furthermore, patients with IDC had 2.14‑fold higher odds of death and 2.44‑fold higher odds of recurrence/distant metastasis/death than patients with IDC + DCIS. The present study supports the behavioral differences of IDC and IDC + DCIS and suggests these two groups of tumors may also behave differently in terms of antitumor immune response. As the DCIS component is positively associated with favorable prognostic features, the presence of the DCIS is associated with improved DFS and OS. DCIS accompaniment may have prognostic value for patients with breast cancer. 
View Figures

Figure 1

Kaplan-Meier curve for disease-free
and overall survival analysis for the entire cohort. IDC, invasive
ductal carcinoma; DCIS, ductal carcinoma in situ.

Figure 2

Kaplan-Meier curve for disease-free
and overall survival analysis on luminal type breast cancer for the
entire cohort. IDC, invasive ductal carcinoma; DCIS, ductal
carcinoma in situ.

Figure 3

Kaplan-Meier curve for disease free
and overall survival analysis based on HER2-positive breast cancer
for the entire cohort. IDC, invasive ductal carcinoma; DCIS, ductal
carcinoma in situ; HER2, human epidermal growth factor
receptor 2.

Figure 4

Kaplan-Meier curve for disease-free
and overall survival analysis based on triple-negative breast
cancer for the entire cohort. IDC, invasive ductal carcinoma; DCIS,
ductal carcinoma in situ.

Figure 5

DFS and OS analysis based on stromal
tumor infiltrating lymphocytes distribution for the entire cohort.
TIL, tumor infiltrating lymphocyte; DFS, disease-free survival; OS,
overall survival.
View References

1 

Siegel RL, Miller KD, Fuchs HE and Jemal A: Cancer statistics, 2021. CA Cancer J Clin. 71:7–33. 2021.PubMed/NCBI View Article : Google Scholar

2 

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A and Bray F: Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 71:209–249. 2021.PubMed/NCBI View Article : Google Scholar

3 

Li CI, Uribe DJ and Daling JR: Clinical characteristics of different histologic types of breast cancer. Br J Cancer. 93:1046–1052. 2005.PubMed/NCBI View Article : Google Scholar

4 

Sgroi DC: Preinvasive breast cancer. Annu Rev Pathol. 5:193–221. 2010.PubMed/NCBI View Article : Google Scholar

5 

Espina V and Liotta LA: What is the malignant nature of human ductal carcinoma in situ? Nat Rev Cancer. 11:68–75. 2011.PubMed/NCBI View Article : Google Scholar

6 

Chagpar AB, McMasters KM, Sahoo S and Edwards MJ: Does ductal carcinoma in situ accompanying invasive carcinoma affect prognosis? Surgery. 146:561–567. 2009.PubMed/NCBI View Article : Google Scholar

7 

Wong H, Lau S, Yau T, Cheung P and Epstein RJ: Presence of an in situ component is associated with reduced biological aggressiveness of size-matched invasive breast cancer. Br J Cancer. 102:1391–1396. 2010.PubMed/NCBI View Article : Google Scholar

8 

Kole AJ, Park HS, Johnson SB, Kelly JR, Moran MS and Patel AA: Overall survival is improved when DCIS accompanies invasive breast cancer. Sci Rep. 9(9934)2019.PubMed/NCBI View Article : Google Scholar

9 

Cowell CF, Weigelt B, Sakr RA, Ng CK, Hicks J, King TA and Reis-Filho JS: Progression from ductal carcinoma in situ to invasive breast cancer: Revisited. Mol Oncol. 7:859–869. 2013.PubMed/NCBI View Article : Google Scholar

10 

Lesurf R, Aure MR, Mørk HH and Vitelli V: Oslo Breast Cancer Research Consortium (OSBREAC). Lundgren S, Børresen-Dale AL, Kristensen V, Wärnberg F, Hallett M and Sørlie T: Molecular features of subtype-specific progression from ductal carcinoma in situ to invasive breast cancer. Cell Rep. 16:1166–1179. 2016.PubMed/NCBI View Article : Google Scholar

11 

Chen H, Bai F, Wang M, Zhang M, Zhang P and Wu K: The prognostic significance of co-existence ductal carcinoma in situ in invasive ductal breast cancer: A large population-based study and a matched case-control analysis. Ann Transl Med. 7(484)2019.PubMed/NCBI View Article : Google Scholar

12 

Galon J, Angell HK, Bedognetti D and Marincola FM: The continuum of cancer immunosurveillance: Prognostic, predictive, and mechanistic signatures. Immunity. 39:11–26. 2013.PubMed/NCBI View Article : Google Scholar

13 

Whiteside TL: Tumor-infiltrating lymphocytes and their role in solid tumor progression. Exp Suppl. 113:89–106. 2022.PubMed/NCBI View Article : Google Scholar

14 

Kashiwagi S, Asano Y, Goto W, Takada K, Takahashi K, Hatano T, Takashima T, Tomita S, Motomura H, Ohsawa M, et al: Using TILs to predict therapeutic effect of chemotherapy (Pertuzumab, Trastuzumab, Docetaxel) on HER2-positive breast cancer. Anticancer Res. 37:5623–5630. 2017.PubMed/NCBI View Article : Google Scholar

15 

Denkert C, von Minckwitz G, Darb-Esfahani S, Lederer B, Heppner BI, Weber KE, Budczies J, Huober J, Klauschen F, Furlanetto J, et al: Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer: A pooled analysis of 3771 patients treated with neoadjuvant therapy. Lancet Oncol. 19:40–50. 2018.PubMed/NCBI View Article : Google Scholar

16 

Giuliano AE, Connolly JL, Edge SB, Mittendorf EA, Rugo HS, Solin LJ, Weaver DL, Winchester DJ and Hortobagyi GN: Breast cancer-major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 67:290–303. 2017.PubMed/NCBI View Article : Google Scholar

17 

Shao N, Xie C, Shi Y, Ye R, Long J, Shi H, Shan Z, Thompson AM and Lin Y: Comparison of the 7th and 8th edition of American Joint Committee on Cancer (AJCC) staging systems for breast cancer patients: A Surveillance, Epidemiology and End Results (SEER) Analysis. Cancer Manag Res. 11:1433–1442. 2019.PubMed/NCBI View Article : Google Scholar

18 

Lopez Gordo S, Blanch Falp J, Lopez-Gordo E, Just Roig E, Encinas Mendez J and Seco Calvo J: Influence of ductal carcinoma in situ on the outcome of invasive breast cancer. A prospective cohort study. Int J Surg. 63:98–106. 2019.PubMed/NCBI View Article : Google Scholar

19 

Goh CW, Wu J, Ding S, Lin C, Chen X, Huang O, Chen W, Li Y, Shen K and Zhu L: Invasive ductal carcinoma with coexisting ductal carcinoma in situ (IDC/DCIS) versus pure invasive ductal carcinoma (IDC): A comparison of clinicopathological characteristics, molecular subtypes, and clinical outcomes. J Cancer Res Clin Oncol. 145:1877–1886. 2019.PubMed/NCBI View Article : Google Scholar

20 

Zhou S, Shi Y, Huang Z, Teng Y and Xing W: Does the presence of ductal carcinoma in situ affect prognostic outcomes after neoadjuvant therapy in invasive ductal carcinoma of the breast? Clin Oncol (R Coll Radiol). 40(103781)2025.PubMed/NCBI View Article : Google Scholar

21 

Liu Y and Yu T: Clinicopathological characteristics and prognosis of triple-negative breast cancer invasive ductal carcinoma with ductal carcinoma in situ. J Cancer Res Clin Oncol. 149:11181–11191. 2023.PubMed/NCBI View Article : Google Scholar

22 

Lam BM and Verrill C: Clinical significance of tumour-infiltrating B lymphocytes (TIL-Bs) in breast cancer: A systematic literature review. Cancers (Basel). 15(1164)2023.PubMed/NCBI View Article : Google Scholar

23 

Loi S, Michiels S, Salgado R, Sirtaine N, Jose V, Fumagalli D, Kellokumpu-Lehtinen PL, Bono P, Kataja V, Desmedt C, et al: Tumor infiltrating lymphocytes are prognostic in triple negative breast cancer and predictive for trastuzumab benefit in early breast cancer: Results from the FinHER trial. Ann Oncol. 25:1544–1550. 2014.PubMed/NCBI View Article : Google Scholar

24 

Schüler K, Bethmann D, Kaufhold S, Hartung C, Stückrath K, Lantzsch T, Uleer C, Hanf V, Peschel S, John J, et al: Prognostic value of tumour-infiltrating lymphocytes in an unselected cohort of breast cancer patients. Diagnostics (Basel). 12(2527)2022.PubMed/NCBI View Article : Google Scholar

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Copy and paste a formatted citation
Spandidos Publications style
Fedai NK, Koc I, Kavgaci G, Uner M, Uner A, Aksoy S and Kertmen N: Prognostic significance of ductal carcinoma <em>in situ</em> coexisting with invasive ductal carcinoma: Biological behavior, immune response and survival outcomes. Mol Clin Oncol 24: 1, 2026.
APA
Fedai, N.K., Koc, I., Kavgaci, G., Uner, M., Uner, A., Aksoy, S., & Kertmen, N. (2026). Prognostic significance of ductal carcinoma <em>in situ</em> coexisting with invasive ductal carcinoma: Biological behavior, immune response and survival outcomes. Molecular and Clinical Oncology, 24, 1. https://doi.org/10.3892/mco.2025.2910
MLA
Fedai, N. K., Koc, I., Kavgaci, G., Uner, M., Uner, A., Aksoy, S., Kertmen, N."Prognostic significance of ductal carcinoma <em>in situ</em> coexisting with invasive ductal carcinoma: Biological behavior, immune response and survival outcomes". Molecular and Clinical Oncology 24.1 (2026): 1.
Chicago
Fedai, N. K., Koc, I., Kavgaci, G., Uner, M., Uner, A., Aksoy, S., Kertmen, N."Prognostic significance of ductal carcinoma <em>in situ</em> coexisting with invasive ductal carcinoma: Biological behavior, immune response and survival outcomes". Molecular and Clinical Oncology 24, no. 1 (2026): 1. https://doi.org/10.3892/mco.2025.2910
Copy and paste a formatted citation
x
Spandidos Publications style
Fedai NK, Koc I, Kavgaci G, Uner M, Uner A, Aksoy S and Kertmen N: Prognostic significance of ductal carcinoma <em>in situ</em> coexisting with invasive ductal carcinoma: Biological behavior, immune response and survival outcomes. Mol Clin Oncol 24: 1, 2026.
APA
Fedai, N.K., Koc, I., Kavgaci, G., Uner, M., Uner, A., Aksoy, S., & Kertmen, N. (2026). Prognostic significance of ductal carcinoma <em>in situ</em> coexisting with invasive ductal carcinoma: Biological behavior, immune response and survival outcomes. Molecular and Clinical Oncology, 24, 1. https://doi.org/10.3892/mco.2025.2910
MLA
Fedai, N. K., Koc, I., Kavgaci, G., Uner, M., Uner, A., Aksoy, S., Kertmen, N."Prognostic significance of ductal carcinoma <em>in situ</em> coexisting with invasive ductal carcinoma: Biological behavior, immune response and survival outcomes". Molecular and Clinical Oncology 24.1 (2026): 1.
Chicago
Fedai, N. K., Koc, I., Kavgaci, G., Uner, M., Uner, A., Aksoy, S., Kertmen, N."Prognostic significance of ductal carcinoma <em>in situ</em> coexisting with invasive ductal carcinoma: Biological behavior, immune response and survival outcomes". Molecular and Clinical Oncology 24, no. 1 (2026): 1. https://doi.org/10.3892/mco.2025.2910
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