Everybody needs good neighbours: the progressive DCIS microenvironment

Ductal carcinoma in situ (DCIS) is a pre-invasive form of breast cancer where neo-plastic luminal cells are confined to the ductal tree. While as many as 70% of DCIS cases will remain indolent, most women are treated with surgery, often combined with endocrine and radiotherapies. Overtreatment is therefore a major issue, de-manding new methods to stratify patients. Somewhat paradoxically, the neoplastic cells in DCIS are genetically comparable to those in invasive disease, suggesting the tumour microenvironment is the driving force for progression. Clinical and mechanistic studies highlight the complex DCIS microenvironment, with multiple cell types competing to regulate progression. Here, we examine recent studies detailing distinct aspects of the DCIS microenvironment and discuss how these may inform more effective care.

Automated summary

Ductal carcinoma in situ (DCIS) is a pre-invasive form of breast cancer characterized by neoplastic luminal cells confined to the ductal tree. While most cases will remain indolent, overtreatment is a concern and new methods are needed to stratify patients. Recent studies have focused on the complex microenvironment of DCIS, highlighting the role of different cell types in regulating tumor progression. Understanding these aspects may lead to more effective care for patients.