The estrogen receptor (ER) plays a key role in predicting long-term outcomes in patients with ductal carcinoma in situ (DCIS), researchers from Queen Mary University of London reported in a study published online March 16 in Clinical Cancer Research.
After analyzing samples from the randomized U.K., Australia, and New Zealand (U.K./ANZ) DCIS trial, the authors led by Dr. Mangesh Thorat, PhD, found multiclonality in ER expression in 11% of ER-positive DCIS. What's more, they concluded that multiclonal ER had a greater than three-fold higher risk of ipsilateral recurrence than ER-negative DCIS. As a result, the researchers said that ER -- and its clonality -- should be routinely assessed in DCIS patients.
"Routine testing of ER in DCIS will help to avoid both overtreatment and undertreatment in this type of breast cancer," Thorat said in a statement from Queen Mary University of London. "The insights from this study will also help improve future breast cancer research through use of new scientific models, particularly in areas of drug resistance and the use of targeted therapies."
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
