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Ductal carcinoma in situ (DCIS) cells may be able to invade, and perhaps metastasize, from the outset rather than being transformed to acquire this behavior, according to new findings.

Ductal carcinoma in situ (DCIS) cells may be able to invade, and perhaps metastasize, from the outset rather than being transformed to acquire this behavior.

This finding "can profoundly alter future strategies for cancer screening and treatment," said Dr. Lance A. Liotta of George Mason University in Fairfax, Virginia, while presenting his team's findings at the Department of Defense's annual Era of Hope breast cancer meeting in Baltimore, Maryland.

Dr. Liotta and colleagues conducted living tissue laser microdissection to test the malignant phenotype of harvested DCIS tissue and to map the proteomic signal pathway profile of DCIS tissue, which was then compared with matched invasive cancer tissue, normal tissue, hyperplastic tissue and benign-appearing breast tissue.

"We've generally thought that DCIS cells become metastatic later on, but it appears that the metastatic potential might be there from the outset," Dr. Liotta said in an interview with Reuters Health prior to his presentation.

"The phenotype of invasion is already present in the stromal phase," he reported. "Now we need to see if we can get the DCIS lesions to grow and invade and become breast cancer and to identify the molecular and tissue structural factors that keep the DCIS cancer stem cells in check. We've been able to do this in very preliminary work."

"Signaling pathways are being activated" that give stromal cells the ability to invade surrounding tissue," Dr. Liotta announced. "Aggressive phenotypes can be seen very early on."

"It is possible that it is initially normal tissue and that it sustains some sort of genetic hit that activates these pathways. The hypoxic environment of the ducts may be this trigger, causing the basement membrane to begin to break down," he speculated. "But that is a lot to ask of a cell -- to go from normal to invasive in one step -- so that is unlikely."

"Dissection of the stromal tissue of a normal duct shows that the tissue there is very different from that in DCIS," Dr. Liotta explained. "Since there is a trigger that causes these changes in invasive capability, the question now is, 'can we block those triggers?'"