Management of breast ductal carcinoma in situ in Catalonia, Spain: Results from the Grup Oncologic Calalà-Occità-Catalonia survey with 9-year follow up

Cambra, M.J.; Farrús, Blanca; Moreno, F.; Anglada, L.; Arenas, Meritxell; Ballester, R.; Casals, Joan; Cusidó, Maite; García, Víctor Manuel Pérez; Gutiérrez, Cristina; Mollà, Meritxell; Pedro, A.; Reyes, V.; Sanz, X.

doi:10.1016/j.breast.2017.08.002

Cited by 5 publications

(3 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this retrospective longitudinal cohort study of 211 BCStreated DCIS patients, we observed an overall low recurrence rate of 3.3% after a median follow-up of 124 months, which was likely due to radiotherapy since most patients were irradiated. Similar low long-term recurrence rates have been reported by others [21], and could be used as a guideline in future trials investigating noninferiority of alternative treatments.…”

Section: Discussionsupporting

confidence: 81%

Stromal characteristics are adequate prognosticators for recurrence risk in ductal carcinoma in situ of the breast

Bockstal

Lambein

Smeets

et al. 2019

European Journal of Surgical Oncology

View full text Add to dashboard Cite

Background: Ductal carcinoma in situ (DCIS) of the breast constitutes a heterogeneous group of nonobligate precursors for invasive breast cancer. To date, adequate risk stratification is lacking, which is presumed to result in overtreatment. We previously identified myxoid stromal architecture as a potential prognosticator for loco-regional recurrence. In the present study, we investigated the prognostic potential of stromal characteristics. Methods: Hematoxylin and eosin stained slides from 211 DCIS patients were reviewed. The following histological features were dichotomously assessed: nuclear grade, DCIS architecture, presence of necrosis, intraductal calcifications, stromal inflammation and myxoid stromal architecture. Loco-regional recurrences constituted the primary endpoint. Results: Cox regression analysis showed that high nuclear grade, myxoid stromal architecture and moderate to extensive stromal inflammation were significantly associated with decreased recurrence-free survival, independent of radiotherapy. Based on these features, a combined risk score (CRS) was calculated, ranging from zero to three. A high CRS of three was associated with significantly shorter recurrence-free survival. Nineteen patients had a CRS of three, of which three relapsed (15.7%), whereas only one out of 113 patients with a CRS of zero relapsed (0.9%). Conclusions: We were able to validate our previously reported findings regarding the prognostic potential of myxoid periductal stroma in an independent DCIS patient cohort. A CRS based on nuclear grade, myxoid stromal architecture and stromal inflammation might facilitate discrimination of low risk from high risk patients. Consequently, the CRS may tailor adjuvant therapy. Future research should investigate whether radiotherapy can be safely omitted in patients with a low CRS.

show abstract

Section: Discussionsupporting

confidence: 81%

Stromal characteristics are adequate prognosticators for recurrence risk in ductal carcinoma in situ of the breast

Bockstal

Lambein

Smeets

et al. 2019

European Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…Few studies have compared all-cause mortality rates of women with DCIS to the general population, most of which are in northern Europe [14][15][16][17] and the US [18]. Considering the possible differences in prevention plans, detection and treatment approaches between countries [19][20][21][22], it becomes relevant to provide evidence on all-cause mortality for patients diagnosed with a DCIS in regions where is not yet available, such as Southern Europe.…”

Section: Introductionmentioning

confidence: 99%

Mortality of women with ductal carcinoma in situ of the breast: a population-based study from the Girona province, Spain (1994–2013)

et al. 2018

View full text Add to dashboard Cite

Purpose We aim to comprehensively describe the incidence and mortality trends of ductal carcinoma in situ (DCIS) in the Girona province, Spain (1994 and to estimate the all-cause mortality excess risk of diagnosed women. Methods Age-standardized rates of DCIS were estimated between 1994 and 2013. Standard mortality ratios (SMR) and absolute excess mortality were calculated overall and by tumor and patient characteristics. A sensitivity analysis was conducted excluding cases with a subsequent invasive breast cancer (sIBC). Results Of the 641 women included, 56 died (follow-up time: 8.4 person-years). Between 1994 and 2013, a significant increase in incidence and decrease in mortality was identified among women aged between 50 and 69 years old. Neoplasms and circulatory system disease were the most common causes of death. No excess risk of death was found overall, except for women aged < 50 years (SMR = 3.44, 95% CI 1.85; 6.40) and those with a sIBC (SMR = 2.51, 95% CI 1.26; 5.02), risk that lessened when cases with sIBC were excluded. Patients with sIBC also showed an excess risk (SMR = 2.29, 95% CI 1.03; 5.10). Conclusions Among women aged 50-69 years old, incidence of DCIS has significantly increased yet mortality has decreased. Overall, the all-cause mortality risk of women diagnosed with DCIS remains similar to that of the general population except for women diagnosed before age 50 and those with sIBC, who showed a significant increased risk. Differential management of these patients should be considered.

show abstract

“…However, treatment patterns within our institution are similar to those recently reported for Catalonia. 23 Regarding potential losses to follow-up, we used additional data sources (HC3) to minimize their impact. Relevant changes in DCIS diagnosis and treatment (such as mammogram equipment, margin free of disease width, biomarker testing, and treatment) have occurred over the study period (which includes cancers diagnosed between 2000 and 2010).…”

Section: Discussionmentioning

confidence: 99%

Readmissions and complications in breast ductal carcinoma in situ: A retrospective study comparing screen- and non-screen-detected patients

Politi

Sala

Domingo

et al. 2020

Womens Health (Lond Engl)

View full text Add to dashboard Cite

Objective: Population-wide mammographic screening programs aim to reduce breast cancer mortality. However, a broad view of the harms and benefits of these programs is necessary to favor informed decisions, especially in the earliest stages of the disease. Here, we compare the outcomes of patients diagnosed with breast ductal carcinoma in situ in participants and non-participants of a population-based mammographic screening program. Methods: A retrospective cohort study of all patients diagnosed with breast ductal carcinoma in situ between 2000 and 2010 within a single hospital. A total of 211 patients were included, and the median follow-up was 8.4 years. The effect of detection mode (screen-detected and non-screen-detected) on breast cancer recurrences, readmissions, and complications was evaluated through multivariate logistic regression analysis. Results: In the majority of women, breast ductal carcinoma in situ was screen-detected (63.5%). Screen-detected breast ductal carcinoma in situ was smaller in size compared to those non-screen-detected (57.53% < 20 mm versus 78.03%, p = 0.002). Overall, breast-conserving surgery was the most frequent surgery (86.26%); however, mastectomy was higher in non-screen-detected breast ductal carcinoma in situ (20.78% versus 9.7%, p = 0.024). Readmissions for mastectomy were more frequent in non-screen-detected breast ductal carcinoma in situ. Psychological complications, such as fatigue, anxiety, and depression, had a prevalence of 15% within our cohort. Risk of readmissions and complications was higher within the non-screen-detected group, as evidenced by an odds ratio = 6.25 (95% confidence interval = 1.95–19.99) for readmissions and an odds ratio = 2.41 (95% confidence interval = 1.95–4.86) for complications. Conclusions: Our findings indicate that women with breast ductal carcinoma in situ breast cancer diagnosed through population-based breast cancer screening program experience a lower risk of readmissions and complications than those diagnosed outside these programs. These findings can help aid women and health professionals make informed decisions regarding screening.

show abstract

Management of breast ductal carcinoma in situ in Catalonia, Spain: Results from the Grup Oncologic Calalà-Occità-Catalonia survey with 9-year follow up

Cited by 5 publications

References 48 publications

Stromal characteristics are adequate prognosticators for recurrence risk in ductal carcinoma in situ of the breast

Stromal characteristics are adequate prognosticators for recurrence risk in ductal carcinoma in situ of the breast

Mortality of women with ductal carcinoma in situ of the breast: a population-based study from the Girona province, Spain (1994–2013)

Readmissions and complications in breast ductal carcinoma in situ: A retrospective study comparing screen- and non-screen-detected patients

Contact Info

Product

Resources

About