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It also consolidates research tools such as preclinical models, single-cell sequencing, spatial transcriptomics, and artificial intelligence, and discusses prognostic biomarkers and clinical management advances to support more personalized treatment 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IDC?",{"text":72,"@type":64},"The review systematically summarizes preclinical models and newer technologies including single-cell sequencing, spatial transcriptomics, and artificial intelligence.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},331972,1790077677,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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Targeted Therapy www.nature.com/sigtrans)  \nREVIEW ARTICLE  \nOPEN  \nProgression from ductal carcinoma in situ to invasive breast cancer: molecular features and clinical significance  \nJing Wang 1,2,3, Baizhou Li4, Meng Luo1,3,5, Jia Huang 1,3, Kun Zhang2, Shu Zheng 1,3, Suzhan Zhang 1,3 ✉ and Jiaojiao Zhou 1,2,3,6 ✉  \n\n|  | Ductal carcinoma in situ (DCIS) represents pre-invasive breast carcinoma. In untreated cases, 25–60% DCIS progress to invasive ductal carcinoma (IDC). The challenge lies in distinguishing between non-progressive and progressive DCIS, often resulting in overor under-treatment in many cases. With increasing screen-detected DCIS in these years, the nature of DCIS has aroused worldwide attention. A deeper understanding of the biological nature of DCIS and the molecular journey of the DCIS-IDC transition is crucial for more effective clinical management. Here, we reviewed the key signaling pathways in breast cancer that may contribute to DCIS initiation and progression. We also explored the molecular features of DCIS and IDC, shedding light on the progression of DCIS through both inherent changes within tumor cells and alterations in the tumor microenvironment. In addition, valuable research tools utilized in studying DCIS including preclinical models and newer advanced technologies such as single-cell sequencing, spatial transcriptomics and artificial intelligence, have been systematically summarized. Further, we thoroughly discussed the clinical advancements in DCIS and IDC, including prognostic biomarkers and clinical managements, with the aim of facilitating more personalized treatment strategies in the future. Research on DCIS has already yielded significant insights into breast |  |\n| --- | --- | --- |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n| carcinogenesis and will continue to pave the way for practical clinical applications. |  |  |\n|  | Signal Transduction and Targeted Therapy (2024)9:83 ; [https://doi.org/10.1038/s41392-024-01779-3](https://doi.org/10.1038/s41392-024-01779-3) |  |\n|  |  |  |\n\nINTRODUCTION  \nDuctal carcinoma in situ (DCIS) is a stage 0 breast cancer characterized by the abnormal proliferation of epithelial cells within the ductal-lobular system of the breast. It accounts for approximately 20% cases of newly diagnosed breast cancer.1–3 Based on architectural patterns, DCIS has been classified into comedo, papillary, solid, cribriform, and micropapillary subtypes.4 Based on the histopathologic nuclear features, DCIS can present asa spectrum, with low-grade (I), intermediate-grade (II), and highgrade (III) lesions; the latter are associated with a higher likelihood of invasive ductal carcinoma (IDC) .5,6 DCIS is commonly considered as a direct precursor to IDC. Studies have reported that approximately 25–60% of untreated DCIS cases progressed to IDC within 9–24 years of follow-up, based on the limited sample size statistics.7–10 However, the natural history and definite etiology of these two disease classifications remain poorly understood. Nevertheless, the development of novel technologies has offered new insights into these lesions. In this context, discoveries related to the initiation and progression of DCIS and IDC are essential for further investigation into their origin and clinical management.  \nDCIS is often categorized as non-invasive or pre-invasive stage of breast cancer. Nonetheless, our understanding of the underlying causes of DCIS as well as how it progressed to be invasive is limited.11, 12 Notably, similarities and differences have been observed between DCIS and IDC. Over the years, the rapid increase in the incidence of DCIS has accompanied the  \nwidespread adoption of mammography (mostly based on screening-detected calcifications) .13–15 In this context, mammographic calcification is more f","cbCainfSJGKuFgkT","https://ap.wps.com/l/cbCainfSJGKuFgkT","pdf",4825705,28,"English","# INTRODUCTION\n## DCIS as a pre-invasive stage and clinical challenge\n## Histologic and intrinsic subtype frameworks\n## Molecular features and risk/prognosis considerations\n# REVIEW SCOPE AND SUMMARY\n## Key signaling pathways and DCIS–IDC transition mechanisms\n## Research tools: preclinical models, single-cell, spatial transcriptomics, AI\n## Clinical advancements: biomarkers and management","[{\"question\":\"What problem does the review address in DCIS management?\",\"answer\":\"It targets the difficulty of distinguishing non-progressive from progressive DCIS, which can lead to over- or under-treatment.\"},{\"question\":\"How does DCIS differ from invasive ductal carcinoma at the tissue level?\",\"answer\":\"DCIS cells remain confined to the mammary ductal-lobular system with intact myoepithelial layer and basement membrane, whereas IDC escapes the myoepithelial layer and invades surrounding tissue.\"},{\"question\":\"Which research tools are summarized for studying DCIS and IDC?\",\"answer\":\"The review systematically summarizes preclinical models and newer technologies including single-cell sequencing, spatial transcriptomics, and artificial intelligence.\"}]","Progression from ductal carcinoma in situ to invasive breast cancer - molecular features and clinical significance | PDF",1789996091,71]