Cargando…
Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion
BACKGROUND: Ductal carcinoma in situ with microinvasion (DCISM) represents ~1% of all breast cancer cases and is arguably a more aggressive subtype of ductal carcinoma in situ (DCIS). Lacking studies with a large population, the survival outcomes of DCISM are still poorly understood and the treatmen...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525113/ https://www.ncbi.nlm.nih.gov/pubmed/34547183 http://dx.doi.org/10.1002/cam4.4263 |
_version_ | 1784585625553338368 |
---|---|
author | Li, Chunyan Yang, Yilan Wang, Jiangfeng Jin, Kairui Yang, Zhaozhi Yu, Xiaoli Guo, Xiaomao Chen, Xingxing |
author_facet | Li, Chunyan Yang, Yilan Wang, Jiangfeng Jin, Kairui Yang, Zhaozhi Yu, Xiaoli Guo, Xiaomao Chen, Xingxing |
author_sort | Li, Chunyan |
collection | PubMed |
description | BACKGROUND: Ductal carcinoma in situ with microinvasion (DCISM) represents ~1% of all breast cancer cases and is arguably a more aggressive subtype of ductal carcinoma in situ (DCIS). Lacking studies with a large population, the survival outcomes of DCISM are still poorly understood and the treatment recommendations remain controversial. This study aims to investigate the long‐term outcome of patients with DCISM, potential risk factors for their prognosis, and the difference of survival between patients treated with breast‐conserving surgery plus radiotherapy (BCT + RT) and mastectomy only. METHODS: In total, 1299 patients from 2008 to 2019 with DCISM were retrospectively retrieved. Clinicopathological features were analyzed. Subgroup analysis was conducted between patients who underwent BCT + RT and mastectomy only. Univariate and multivariate analyses were performed to identify prognostic factors for survival. Differences of survival between two groups were compared using the log‐rank test. RESULTS: Totally, 1286 patients had follow‐up information, the median follow‐up is 54.57 months, the 5‐year local–regional‐free survival (LRFS), distant metastasis‐free survival (DMFS), and overall survival (OS) were 98.6%, 97.1%, and 99.4%, respectively, two deaths were due to breast cancer. Multivariate analysis identified age <40 (p = 0.028) and close margin (≤2 mm) as independent negative prognostic factors for LRFS. No prognostic factors were identified for DMFS and OS. The 5‐year LRFS, DMFS, and OS of patients who had DCIS component ≥5 cm and underwent mastectomy without adjuvant radiotherapy were 100%, 98.4%, and 98.4%, respectively. After propensity score matching (PSM), no survival difference was observed between patients treated with BCT + RT or mastectomy only. CONCLUSIONS: DCISM patients had a good survival, even those with DCIS component ≥5 cm. Patients aged <40 or with close margin (≤2 mm) had a poorer LRFS, but not DMFS or OS. BCT + RT is a feasible choice for DCISM patients. |
format | Online Article Text |
id | pubmed-8525113 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85251132021-10-26 Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion Li, Chunyan Yang, Yilan Wang, Jiangfeng Jin, Kairui Yang, Zhaozhi Yu, Xiaoli Guo, Xiaomao Chen, Xingxing Cancer Med Clinical Cancer Researcher BACKGROUND: Ductal carcinoma in situ with microinvasion (DCISM) represents ~1% of all breast cancer cases and is arguably a more aggressive subtype of ductal carcinoma in situ (DCIS). Lacking studies with a large population, the survival outcomes of DCISM are still poorly understood and the treatment recommendations remain controversial. This study aims to investigate the long‐term outcome of patients with DCISM, potential risk factors for their prognosis, and the difference of survival between patients treated with breast‐conserving surgery plus radiotherapy (BCT + RT) and mastectomy only. METHODS: In total, 1299 patients from 2008 to 2019 with DCISM were retrospectively retrieved. Clinicopathological features were analyzed. Subgroup analysis was conducted between patients who underwent BCT + RT and mastectomy only. Univariate and multivariate analyses were performed to identify prognostic factors for survival. Differences of survival between two groups were compared using the log‐rank test. RESULTS: Totally, 1286 patients had follow‐up information, the median follow‐up is 54.57 months, the 5‐year local–regional‐free survival (LRFS), distant metastasis‐free survival (DMFS), and overall survival (OS) were 98.6%, 97.1%, and 99.4%, respectively, two deaths were due to breast cancer. Multivariate analysis identified age <40 (p = 0.028) and close margin (≤2 mm) as independent negative prognostic factors for LRFS. No prognostic factors were identified for DMFS and OS. The 5‐year LRFS, DMFS, and OS of patients who had DCIS component ≥5 cm and underwent mastectomy without adjuvant radiotherapy were 100%, 98.4%, and 98.4%, respectively. After propensity score matching (PSM), no survival difference was observed between patients treated with BCT + RT or mastectomy only. CONCLUSIONS: DCISM patients had a good survival, even those with DCIS component ≥5 cm. Patients aged <40 or with close margin (≤2 mm) had a poorer LRFS, but not DMFS or OS. BCT + RT is a feasible choice for DCISM patients. John Wiley and Sons Inc. 2021-09-21 /pmc/articles/PMC8525113/ /pubmed/34547183 http://dx.doi.org/10.1002/cam4.4263 Text en © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Researcher Li, Chunyan Yang, Yilan Wang, Jiangfeng Jin, Kairui Yang, Zhaozhi Yu, Xiaoli Guo, Xiaomao Chen, Xingxing Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion |
title | Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion |
title_full | Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion |
title_fullStr | Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion |
title_full_unstemmed | Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion |
title_short | Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion |
title_sort | characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion |
topic | Clinical Cancer Researcher |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525113/ https://www.ncbi.nlm.nih.gov/pubmed/34547183 http://dx.doi.org/10.1002/cam4.4263 |
work_keys_str_mv | AT lichunyan characteristicsprognosisriskfactorsandmanagementofrecentlydiagnosedductalcarcinomainsituwithmicroinvasion AT yangyilan characteristicsprognosisriskfactorsandmanagementofrecentlydiagnosedductalcarcinomainsituwithmicroinvasion AT wangjiangfeng characteristicsprognosisriskfactorsandmanagementofrecentlydiagnosedductalcarcinomainsituwithmicroinvasion AT jinkairui characteristicsprognosisriskfactorsandmanagementofrecentlydiagnosedductalcarcinomainsituwithmicroinvasion AT yangzhaozhi characteristicsprognosisriskfactorsandmanagementofrecentlydiagnosedductalcarcinomainsituwithmicroinvasion AT yuxiaoli characteristicsprognosisriskfactorsandmanagementofrecentlydiagnosedductalcarcinomainsituwithmicroinvasion AT guoxiaomao characteristicsprognosisriskfactorsandmanagementofrecentlydiagnosedductalcarcinomainsituwithmicroinvasion AT chenxingxing characteristicsprognosisriskfactorsandmanagementofrecentlydiagnosedductalcarcinomainsituwithmicroinvasion |