A low risk of recurrence after breast-conserving surgery for DCIS: A single-institution experience
Background: : Previously published studies report up to 30% recurrence rates after DCIS, so it would be desirable to identify those women at risk for recurrence and adapt adjuvant management. This study aimed to identify the locoregional recurrence rate after breast conserving surgery (BCS) for DCIS...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Cancer Treatment and Research Communications |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468294223000278 |
| _version_ | 1797828101324931072 |
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| author | Sara van Bekkum Caroline Drukker Joost van Rosmalen Marian B.E. Menke-Pluijmers Pieter J. Westenend |
| author_facet | Sara van Bekkum Caroline Drukker Joost van Rosmalen Marian B.E. Menke-Pluijmers Pieter J. Westenend |
| author_sort | Sara van Bekkum |
| collection | DOAJ |
| description | Background: : Previously published studies report up to 30% recurrence rates after DCIS, so it would be desirable to identify those women at risk for recurrence and adapt adjuvant management. This study aimed to identify the locoregional recurrence rate after breast conserving surgery (BCS) for DCIS, and to evaluate the possible role of immunohistochemical (IHC) staining in predicting the risk of recurrence. Patients and methods: : In a retrospective cohort study, patients who underwent BCS for pure DCIS were identified. Data on well-established clinical-pathological risk factors and development of locoregional recurrence was gathered from patient files. In addition, IHC stains of ER, PR, HER2, p53, and ki67 were performed on original tumor samples. Univariable Cox regression analyses were performed to identify possible risk factors for locoregional recurrence. Results: : 190 patients were included. At a median follow-up time of 12.8 years fifteen (8%) patients developed locoregional recurrence: 7 invasive cancer and 8 DCIS. These recurrences were diagnosed within a range of 1.7 to 19.6 years after the initial diagnosis. Univariable Cox regression analysis did only show a significant association between p53 and locoregional recurrence. Our re-excision rate to obtain free margins was 30.5%, and 90% received radiotherapy. Endocrine treatment was not used. Conclusions: : At 12.8 years follow-up, patients with DCIS treated with BCS have a very low locoregional recurrence of 8%. Although we could demonstrate that increased p53 expression is a risk factor for locoregional recurrence, we think this is of little clinical value in our population with such a low recurrence rate. Microabstract: : With a published recurrence rate up to 30% after DCIS, it would be desirable to identify those at risk to adapt treatment and follow-up. We aimed to evaluate the role of immunohistochemical staining to determine the risk of locoregional recurrence, in addition to established clinical and pathological risk factors. At a median follow-up of 12.8 years, we found a locoregional recurrence rate of 8%. Increased expression of p53 is associated with an increased risk of locoregional recurrence. |
| first_indexed | 2024-04-09T12:59:39Z |
| format | Article |
| id | doaj.art-20235746865e422db0bb9ce01627cb2a |
| institution | Directory Open Access Journal |
| issn | 2468-2942 |
| language | English |
| last_indexed | 2024-04-09T12:59:39Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Cancer Treatment and Research Communications |
| spelling | doaj.art-20235746865e422db0bb9ce01627cb2a2023-05-13T04:25:32ZengElsevierCancer Treatment and Research Communications2468-29422023-01-0135100706A low risk of recurrence after breast-conserving surgery for DCIS: A single-institution experienceSara van Bekkum0Caroline Drukker1Joost van Rosmalen2Marian B.E. Menke-Pluijmers3Pieter J. Westenend4Department of Surgery, Albert Schweitzer Hospital, Dordrecht the NetherlandsDepartment of Surgical Oncology, Antoni van Leeuwenhoek, Amsterdam, the NetherlandsDepartment of Biostatistics, Erasmus MC, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC, Rotterdam, the NetherlandsDepartment of Surgery, Albert Schweitzer Hospital, Dordrecht the NetherlandsDepartment of Pathology, Laboratory of Pathology, Dordrecht, the Netherlands; Corresponding author at: Karel Lotsyweg 145, 3318 AL Dordrecht, the Netherlands.Background: : Previously published studies report up to 30% recurrence rates after DCIS, so it would be desirable to identify those women at risk for recurrence and adapt adjuvant management. This study aimed to identify the locoregional recurrence rate after breast conserving surgery (BCS) for DCIS, and to evaluate the possible role of immunohistochemical (IHC) staining in predicting the risk of recurrence. Patients and methods: : In a retrospective cohort study, patients who underwent BCS for pure DCIS were identified. Data on well-established clinical-pathological risk factors and development of locoregional recurrence was gathered from patient files. In addition, IHC stains of ER, PR, HER2, p53, and ki67 were performed on original tumor samples. Univariable Cox regression analyses were performed to identify possible risk factors for locoregional recurrence. Results: : 190 patients were included. At a median follow-up time of 12.8 years fifteen (8%) patients developed locoregional recurrence: 7 invasive cancer and 8 DCIS. These recurrences were diagnosed within a range of 1.7 to 19.6 years after the initial diagnosis. Univariable Cox regression analysis did only show a significant association between p53 and locoregional recurrence. Our re-excision rate to obtain free margins was 30.5%, and 90% received radiotherapy. Endocrine treatment was not used. Conclusions: : At 12.8 years follow-up, patients with DCIS treated with BCS have a very low locoregional recurrence of 8%. Although we could demonstrate that increased p53 expression is a risk factor for locoregional recurrence, we think this is of little clinical value in our population with such a low recurrence rate. Microabstract: : With a published recurrence rate up to 30% after DCIS, it would be desirable to identify those at risk to adapt treatment and follow-up. We aimed to evaluate the role of immunohistochemical staining to determine the risk of locoregional recurrence, in addition to established clinical and pathological risk factors. At a median follow-up of 12.8 years, we found a locoregional recurrence rate of 8%. Increased expression of p53 is associated with an increased risk of locoregional recurrence.http://www.sciencedirect.com/science/article/pii/S2468294223000278DCISBreast conserving surgeryRecurrence |
| spellingShingle | Sara van Bekkum Caroline Drukker Joost van Rosmalen Marian B.E. Menke-Pluijmers Pieter J. Westenend A low risk of recurrence after breast-conserving surgery for DCIS: A single-institution experience Cancer Treatment and Research Communications DCIS Breast conserving surgery Recurrence |
| title | A low risk of recurrence after breast-conserving surgery for DCIS: A single-institution experience |
| title_full | A low risk of recurrence after breast-conserving surgery for DCIS: A single-institution experience |
| title_fullStr | A low risk of recurrence after breast-conserving surgery for DCIS: A single-institution experience |
| title_full_unstemmed | A low risk of recurrence after breast-conserving surgery for DCIS: A single-institution experience |
| title_short | A low risk of recurrence after breast-conserving surgery for DCIS: A single-institution experience |
| title_sort | low risk of recurrence after breast conserving surgery for dcis a single institution experience |
| topic | DCIS Breast conserving surgery Recurrence |
| url | http://www.sciencedirect.com/science/article/pii/S2468294223000278 |
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