Dataset Information

Cancer Outcomes in DCIS Patients Without Locoregional Treatment.

ABSTRACT:

Background

The vast majority of women diagnosed with ductal carcinoma in situ (DCIS) undergo treatment. Therefore, the risks of invasive progression and competing death in the absence of locoregional therapy are uncertain.

Methods

We performed survival analyses of patient-level data from DCIS patients who did not receive definitive surgery or radiation therapy as recorded in the US National Cancer Institute's Surveillance, Epidemiology, and End Results program (1992-2014). Kaplan-Meier curves were used to estimate the net risk of subsequent ipsilateral invasive cancer. The cumulative incidences of ipsilateral invasive cancer, contralateral breast cancer, and death were estimated using competing risk methods.

Results

A total of 1286 DCIS patients who did not undergo locoregional therapy were identified. Median age at diagnosis was 60?years (inter-quartile range = 51-74 years), with median follow-up of 5.5?years (inter-quartile range = 2.3-10.6 years). Among patients with tumor grade I/II (n?=?547), the 10-year net risk of ipsilateral invasive breast cancer was 12.2% (95% confidence interval [CI] = 8.6% to 17.1%) compared with 17.6% (95% CI = 12.1% to 25.2%) among patients with tumor grade III (n?=?244) and 10.1% (95% CI = 7.4% to 13.8%) among patients with unknown grade (n?=?495). Among all patients, the 10-year cumulative incidences of ipsilateral invasive cancer, contralateral breast cancer, and all-cause mortality were 10.5% (95% CI = 8.5% to 12.4%), 3.9% (95% CI = 2.6% to 5.2%), and 24.1% (95% CI = 21.2% to 26.9%), respectively.

Conclusion

Despite limited data, our findings suggest that DCIS patients without locoregional treatment have a limited risk of invasive progression. Although the cohort is not representative of the general population of patients diagnosed with DCIS, the findings suggest that there may be overtreatment, especially among older patients and patients with elevated comorbidities.

SUBMITTER: Ryser MD

PROVIDER: S-EPMC6748726 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Cancer Outcomes in DCIS Patients Without Locoregional Treatment.

Ryser Marc D MD Weaver Donald L DL Zhao Fengmin F Worni Mathias M Grimm Lars J LJ Gulati Roman R Etzioni Ruth R Hyslop Terry T Lee Sandra J SJ Hwang E Shelley ES

Journal of the National Cancer Institute 20190901 9

<h4>Background</h4>The vast majority of women diagnosed with ductal carcinoma in situ (DCIS) undergo treatment. Therefore, the risks of invasive progression and competing death in the absence of locoregional therapy are uncertain.<h4>Methods</h4>We performed survival analyses of patient-level data from DCIS patients who did not receive definitive surgery or radiation therapy as recorded in the US National Cancer Institute's Surveillance, Epidemiology, and End Results program (1992-2014). Kaplan- ...[more]

PMID: 30759222

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Dataset Information

Cancer Outcomes in DCIS Patients Without Locoregional Treatment.

Background

Methods

Results

Conclusion

Publications

Cancer Outcomes in DCIS Patients Without Locoregional Treatment.

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