Trial Information

Breast Cancer Prevention by Inducing Apoptosis in DCIS Using Breast Ductal Lavage

OBJECTIVES:

- Determine the expression pattern of the programmed cell death (PCD) regulatory genes
bcl-2, bax, and bcl-xL in primary ductal carcinoma in situ (DCIS) cultures.

- Determine whether down-regulation by genetic manipulation of the anti-apoptotic genes
bcl-2 and/or bcl-xL, alone or in conjunction with physiological preventive doses of
tamoxifen citrate, has the highest induction of PCD in primary DCIS cell cultures.

- Determine the expression pattern of the PCD regulatory genes bcl-2, bax, and bcl-xL in
cells obtained by breast ductal lavage.

- Determine whether down-regulation by genetic manipulation of the anti-apoptotic genes
bcl-2 and/or bcl-xL, alone or in conjunction with physiological preventive doses of
tamoxifen citrate, has the highest induction of PCD in cells obtained by breast ductal
lavage.

OUTLINE: Patients undergo breast lavage to collect primary epithelial cells for cytological
analysis before a planned surgical procedure. Ductal carcinoma in situ (DCIS) tissue samples
obtained from surgery are used to establish primary DCIS cell cultures. The DCIS cells and
primary epithelial cells obtained by ductal lavage are analyzed for endogenous protein
levels of bcl-2, bax, and bcl-xL, using western blotting and immunohistochemical staining,
to determine the appropriate antisense oligonucleotide molecule that will be used to induce
apoptosis. The DCIS cells and primary epithelial cells obtained by ductal lavage are treated
with antisense oligonucleotides and/or a physiological chemopreventive dose of tamoxifen
citrate to determine which will provide the highest induction of cell death. The effect of
these treatments on protein expression is analyzed by western blotting and
immunohistochemistry. The effect of these treatments on markers of programed cell death
(PCD) (i.e., DNA fragmentation and caspase activation) is also analyzed. Changes in mRNA
expression are analyzed using a PCR-based quantitation assay.

Results from the molecular marker assays are not provided to the patients.