Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion
Abstract 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...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-10-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.4263 |
| _version_ | 1818742473905668096 |
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| author | Chunyan Li Yilan Yang Jiangfeng Wang Kairui Jin Zhaozhi Yang Xiaoli Yu Xiaomao Guo Xingxing Chen |
| author_facet | Chunyan Li Yilan Yang Jiangfeng Wang Kairui Jin Zhaozhi Yang Xiaoli Yu Xiaomao Guo Xingxing Chen |
| author_sort | Chunyan Li |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-18T02:13:05Z |
| format | Article |
| id | doaj.art-52cd27b5234b42788c45e024e4df4354 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-18T02:13:05Z |
| publishDate | 2021-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-52cd27b5234b42788c45e024e4df43542022-12-21T21:24:27ZengWileyCancer Medicine2045-76342021-10-0110207203721210.1002/cam4.4263Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasionChunyan Li0Yilan Yang1Jiangfeng Wang2Kairui Jin3Zhaozhi Yang4Xiaoli Yu5Xiaomao Guo6Xingxing Chen7Department of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaAbstract 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.https://doi.org/10.1002/cam4.4263breast‐conserving treatmentcharacteristicsDCISMmastectomyprognosisradiotherapy |
| spellingShingle | Chunyan Li Yilan Yang Jiangfeng Wang Kairui Jin Zhaozhi Yang Xiaoli Yu Xiaomao Guo Xingxing Chen Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion Cancer Medicine breast‐conserving treatment characteristics DCISM mastectomy prognosis radiotherapy |
| 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 | breast‐conserving treatment characteristics DCISM mastectomy prognosis radiotherapy |
| url | https://doi.org/10.1002/cam4.4263 |
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