BMC Cancer 2008, 8:36 http://www.biomedcentral.com/1471-2407/8/36 tive lesions, since such associations have been reported in invasive breast cancers [48] Conclusion These data suggest that overexpression of COX-2 in DCIS lesions is a strong risk factor for local recurrence in the conserved breast; and that PPARg expression may protect against such recurrence. A larger study is needed to vali- date our findings, which might require a multi-institu- tional effort. If validated, both COX-2 expression and PPARγ expression would provide additional important prognostic information in DCIS where current tools to predict recurrence are inadequate. Additionally, there is the potential for both agents to be administered together given the cross talk between the two markers. Lastly, given that COX-2 and PPARγ are expressed in both invasive and noninvasive breast cancer, it would be useful to study COX-2 and PPARγ expression in atypical proliferations to see if these biomarkers will improve risk estimation, and in the hopes of identifying molecular targets for chemo- prevention. Competing interests The author(s) declare that they have no competing inter- ests. Authors' contributions SK participated in study design, assembled the clinical data set, and wrote the initial draft of the manuscript. DP assisted in the assembly of the pathological materials, and in the performance and interpretation of histochemical stains. LKD and ELW were the pathology referees; LKD supervised the construction of the TMAs and participated in study design. MM contributed to the study design and manuscript revision. SAK conceived of the study, and par- ticipated in its design and coordination. All authors read and approved the final manuscript. 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