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Tumor-Infiltrating Lymphocytes in a Contemporary Cohort of Women with Ductal Carcinoma In Situ (DCIS)

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Growing evidence suggests that the tumor immune microenvironment influences breast cancer development and prognosis. Density of tumor-infiltrating lymphocytes (TILs) within invasive breast cancer is correlated with response to therapy, especially in triple-negative disease. The clinical relevance and outcomes of TILs within ductal carcinoma in situ (DCIS) are less understood.

Methods

Our institutional database of 668 patients with pure DCIS from 2010 to 2018 was queried. TILs were evaluated by International TILs Working Group guidelines. Percentage of TILs was assessed from the densest focus (hotspot) in one high-power field of stroma touching the basement membrane. Statistical methods included cluster analyses (to define sparse versus dense TILs), logistic, and Cox regression models.

Results

Sixty-nine patients with DCIS and TILs were evaluated, of whom 54 (78%) were treated by breast-conserving surgery. Thirteen (19%) patients had ipsilateral recurrence. Each recurrence (n = 13) was matched to four controls (n = 56) based on date of surgery. Median follow-up was 6.7 years. TILs were defined as sparse (< 45%) or dense (≥ 45%). Dense TILs were associated with younger age (p = 0.045), larger tumor size (p < 0.001), high nuclear grade (p = 0.010), comedo histology (p = 0.033), necrosis (p = 0.027), estrogen receptor (ER) negativity (p = 0.037), and ipsilateral recurrence (p = 0.001). Nine patients with dense TILs had mean time to recurrence of 73.5 months compared with four patients with sparse TILs with mean time to recurrence of 97.9 months (p = 0.003).

Conclusions

Dense TILs were significantly associated with age, tumor size, nuclear grade, comedo histology, necrosis, and ER status and was a significant predictor of recurrence in patients with pure DCIS.

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Acknowledgment

We would like to acknowledge the Shifrin–Myers Breast Cancer Discovery Fund for funding this study.

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Authors and Affiliations

  1. Department of Pathology, New York University Langone Health, New York, NY, USA

    Farbod Darvishian MD & Ugur Ozerdem MD

  2. Department of Medicine, New York University Langone Health, New York, NY, USA

    Sylvia Adams MD

  3. Department of Surgery, New York University Langone Health, New York, NY, USA

    Jennifer Chun MPH, Elianna Kaplowitz MPH, Amber Guth MD, Deborah Axelrod MD, Richard Shapiro MD, Alison Price MD, Freya Schnabel MD & Daniel Roses MD

  4. Department of Biostatistics, New York University Langone Health, New York, NY, USA

    Elizabeth Pirraglia MS & Andrea Troxel PhD

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  1. Farbod Darvishian MD
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Correspondence to Freya Schnabel MD.

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This article was presented at The American Society of Breast Surgeons 20th Annual Meeting in Dallas, TX; April 30–May 5, 2019.

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Darvishian, F., Ozerdem, U., Adams, S. et al. Tumor-Infiltrating Lymphocytes in a Contemporary Cohort of Women with Ductal Carcinoma In Situ (DCIS). Ann Surg Oncol 26, 3337–3343 (2019). https://doi.org/10.1245/s10434-019-07562-x

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  • DOI: https://doi.org/10.1245/s10434-019-07562-x

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