Collagen gene expression profiles predict recurrence and progression of DCIS to IDC.

Breast cancer is a major cause of cancer-related morbidity and mortality globally. Ductal carcinoma in situ (DCIS) is a non-invasive precursor to invasive ductal carcinoma (IDC), and understanding the molecular mechanisms driving this transition is critical. This study explores the role of collagen genes (COL1A1, COL1A2, COL3A1, COL5A2) in extracellular matrix (ECM) remodeling and tumor progression. Pathology samples were collected from patients at Rasoul Akram, Asia, and Khatam Al-Anbia Hospitals (2013-2023), including 42 cases (recurrent DCIS and IDC) and 32 controls (primary DCIS without recurrence). RNA was extracted, reverse transcribed, and analyzed via real-time PCR to assess collagen gene expression. Statistical analyses, including ROC curve analysis, were performed to evaluate the predictive performance of collagen gene expression. Results revealed significant upregulation of COL1A1, COL1A2, COL3A1, and COL5A2 in the case group, with fold increases of 9.71, 5.38, 3.16, and 4.63, respectively (p ≤ 0.05). Overexpression was most pronounced in ER-negative, PR-negative, and high Ki67 subtypes, indicating a link to aggressive tumor behavior. ROC analysis demonstrated the potential predictive utility of collagen gene expression profiles, with AUC values ranging from 0.765 to 0.859. These findings underscore the role of collagen genes in breast cancer progression, highlighting their potential as predictive biomarkers and therapeutic targets.