DCIS lesions with high levels of activin A (Figure 7B) were associated with an increase in "activated" fibroblasts, as reflected by the increase in expression of αSMA (P = 0.01), angiogenesis, as illustrated by the increased expression of CD31 (P = 0.04), and immune cell infiltration (P = 0.007) in the adjacent stroma when compared with lesions with low levels of activin A (Figure 7A). Here, ACTA1 is linked to ductal breast carcinoma in situ.