Ductal carcinoma in situ (DCIS) breast cancers are non-invasive but can progress to invasive ductal carcinoma (IDC) through tumor intrinsic and -extrinsic factors that are poorly understood. In this study, Trinh and colleagues model interactions between DCIS/IDC tumors and their respective immune cell infiltrates using integrated molecular analyses. The authors find that IDC tumors are often genetically related to their DCIS precursors despite long periods of latency between the two stages, and that features of the tumor immune microenvironment are established early in tumor development and could shap. the progression to IDC. In particular, recurrent TP53 and PIK3CA mutations were associated with sustained inflammatory immune cell activity across the DCIS-IDC transition. The authors argue that, despite their status as neoantigens, these mutations and others could be retained through immune editing of the tumor. While in-depth study in a diverse cohort is needed, these data suggest a key role for the...

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