Rates of ipsilateral breast tumour recurrence (IBTR) following breast conserving surgery (BCS) and hypofractionated radiotherapy for ductal carcinoma in situ (DCIS)

2016 ◽  
Vol 42 (5) ◽  
pp. S35
Author(s):  
Dorin Dumitru ◽  
Gordon Wishart ◽  
Elena Provenzano ◽  
John Benson
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Breast Tumour ◽  
Tumour Recurrence ◽  
Hypofractionated Radiotherapy ◽  
Ipsilateral Breast ◽  
Ipsilateral Breast Tumour Recurrence

scholarly journals Long-term risk of subsequent ipsilateral lesions after surgery with or without radiotherapy for ductal carcinoma in situ of the breast

2021 ◽  
Author(s):  
Maartje van Seijen ◽  
Esther H. Lips ◽  
Liping Fu ◽  
Daniele Giardiello ◽  
Frederieke van Duijnhoven ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Cumulative Incidence ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Ipsilateral Breast ◽  
Cox Models ◽  
Dcis Treatment ◽  
The Impact

Abstract Background Radiotherapy (RT) following breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS) reduces ipsilateral breast event rates in clinical trials. This study assessed the impact of DCIS treatment on a 20-year risk of ipsilateral DCIS (iDCIS) and ipsilateral invasive breast cancer (iIBC) in a population-based cohort. Methods The cohort comprised all women diagnosed with DCIS in the Netherlands during 1989–2004 with follow-up until 2017. Cumulative incidence of iDCIS and iIBC following BCS and BCS + RT were assessed. Associations of DCIS treatment with iDCIS and iIBC risk were estimated in multivariable Cox models. Results The 20-year cumulative incidence of any ipsilateral breast event was 30.6% (95% confidence interval (CI): 28.9–32.6) after BCS compared to 18.2% (95% CI 16.3–20.3) following BCS  +  RT. Women treated with BCS compared to BCS + RT had higher risk of developing iDCIS and iIBC within 5 years after DCIS diagnosis (for iDCIS: hazard ratio (HR)age < 50 3.2 (95% CI 1.6–6.6); HRage ≥ 50 3.6 (95% CI 2.6–4.8) and for iIBC: HRage<50 2.1 (95% CI 1.4–3.2); HRage ≥ 50 4.3 (95% CI 3.0–6.0)). After 10 years, the risk of iDCIS and iIBC no longer differed for BCS versus BCS + RT (for iDCIS: HRage < 50 0.7 (95% CI 0.3–1.5); HRage ≥ 50 0.7 (95% CI 0.4–1.3) and for iIBC: HRage < 50 0.6 (95% CI 0.4–0.9); HRage ≥ 50 1.2 (95% CI 0.9–1.6)). Conclusion RT is associated with lower iDCIS and iIBC risk up to 10 years after BCS, but this effect wanes thereafter.

scholarly journals Impact of consensus guidelines for breast‐conserving surgery in patients with ductal carcinoma in situ

2021 ◽  
Author(s):  
Abigail Tremelling ◽  
Rebecca L. Aft ◽  
Amy E. Cyr ◽  
William E. Gillanders ◽  
Katherine Glover‐Collins ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Consensus Guidelines

scholarly journals Preoperative breast magnetic resonance imaging in patients with ductal carcinoma in situ: a systematic review for the European Commission Initiative on Breast Cancer (ECIBC)

2021 ◽  
Author(s):  
Carlos Canelo-Aybar ◽  
Alvaro Taype-Rondan ◽  
Jessica Hanae Zafra-Tanaka ◽  
David Rigau ◽  
Axel Graewingholt ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Surgical Outcomes ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conserving Surgery ◽  
Cochrane Library ◽  
Treatment Change ◽  
The Impact

Abstract Objective To evaluate the impact of preoperative MRI in the management of Ductal carcinoma in situ (DCIS). Methods We searched the PubMed, EMBASE and Cochrane Library databases to identify randomised clinical trials (RCTs) or cohort studies assessing the impact of preoperative breast MRI in surgical outcomes, treatment change or loco-regional recurrence. We provided pooled estimates for odds ratios (OR), relative risks (RR) and proportions and assessed the certainty of the evidence using the GRADE approach. Results We included 3 RCTs and 23 observational cohorts, corresponding to 20,415 patients. For initial breast-conserving surgery (BCS), the RCTs showed that MRI may result in little to no difference (RR 0.95, 95% CI 0.90 to 1.00) (low certainty); observational studies showed that MRI may have no difference in the odds of re-operation after BCS (OR 0.96; 95% CI 0.36 to 2.61) (low certainty); and uncertain evidence from RCTs suggests little to no difference with respect to total mastectomy rate (RR 0.91; 95% CI 0.65 to 1.27) (very low certainty). We also found that MRI may change the initial treatment plans in 17% (95% CI 12 to 24%) of cases, but with little to no effect on locoregional recurrence (aHR = 1.18; 95% CI 0.79 to 1.76) (very low certainty). Conclusion We found evidence of low to very low certainty which may suggest there is no improvement of surgical outcomes with pre-operative MRI assessment of women with DCIS lesions. There is a need for large rigorously conducted RCTs to evaluate the role of preoperative MRI in this population. Key Points • Evidence of low to very low certainty may suggest there is no improvement in surgical outcomes with pre-operative MRI. • There is a need for large rigorously conducted RCTs evaluating the role of preoperative MRI to improve treatment planning for DCIS.

scholarly journals Patterns of invasive recurrence among patients originally treated for ductal carcinoma in situ by breast-conserving surgery versus mastectomy

2021 ◽  
Vol 186 (3) ◽  
pp. 617-624
Author(s):  
Kate R. Pawloski ◽  
Audree B. Tadros ◽  
Varadan Sevilimedu ◽  
Ashley Newman ◽  
Lori Gentile ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Advanced Disease ◽  
Breast Conserving Surgery ◽  
Risk Profile ◽  
High Grade ◽  
Group A ◽  
First Recurrence

Abstract Purpose Local recurrence after treatment of ductal carcinoma in situ (DCIS) with breast-conserving surgery (BCS) is more common than after mastectomy, but it is unclear if patterns of invasive recurrence vary by initial surgical therapy. Among patients with invasive recurrence after treatment for DCIS, we compared patterns of first recurrence between those originally treated with BCS vs. mastectomy. Methods From 2000 to 2016, women with an invasive recurrence occurring ≥ 6 months after initial treatment for DCIS were retrospectively identified. Clinicopathologic features and adjuvant treatment of the initial DCIS, as well as characteristics of first invasive recurrences, were compared between patients who had undergone BCS vs. mastectomy. Results 452 patients with an invasive recurrence after surgery for DCIS were identified: 367 patients (81%) had initially undergone BCS and 85 patients (19%) mastectomy. Patients originally treated with mastectomy were younger and were more likely to have had high grade, necrosis, and multifocal or multicentric DCIS (p < 0.001) compared with the BCS group. A higher proportion of invasive recurrences were local after BCS (93%; 343/367), whereas 88% (75/85) of recurrences after mastectomy were regional or distant (p < 0.001). The median time to first invasive recurrence was not different between surgical groups (BCS: 6.4 years vs. mastectomy: 5.5 years; p = 0.12). Conclusions Among women who experienced a first invasive recurrence after treatment for DCIS, those who had originally undergone mastectomy more commonly presented with advanced disease compared to those treated with BCS, likely related to the absence of the breast and the higher risk profile of their initial DCIS.

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