دورية أكاديمية
Association of DCIS size and margin status with risk of developing breast cancer post-treatment: multinational, pooled cohort study
| العنوان: | Association of DCIS size and margin status with risk of developing breast cancer post-treatment: multinational, pooled cohort study |
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| المؤلفون: | Schmitz, Renée S J M, van den Belt-Dusebout, Alexandra W, Clements, Karen, Ren, Yi, Cresta, Chiara, Timbres, Jasmine, Liu, Yat-Hee, Byng, Danalyn, Lynch, Thomas, Menegaz, Brian A, Collyar, Deborah, Hyslop, Terry, Thomas, Samantha, Love, Jason K, Schaapveld, Michael, Bhattacharjee, Proteeti, Ryser, Marc D, Sawyer, Elinor, Hwang, E Shelley, Thompson, Alastair, Wesseling, Jelle, Lips, Esther H, Schmidt, Marjanka K, on behalf of the Grand Challenge PRECISION consortium |
| بيانات النشر: | BMJ Publishing Group Ltd |
| سنة النشر: | 2023 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | RESEARCH |
| الوصف: | Objective To examine the association between size and margin status of ductal carcinoma in situ (DCIS) and risk of developing ipsilateral invasive breast cancer and ipsilateral DCIS after treatment, and stage and subtype of ipsilateral invasive breast cancer. Design Multinational, pooled cohort study. Setting Four large international cohorts. Participants Patient level data on 47 695 women with a diagnosis of pure, primary DCIS between 1999 and 2017 in the Netherlands, UK, and US who underwent surgery, either breast conserving or mastectomy, often followed by radiotherapy or endocrine treatment, or both. Main outcome measures The main outcomes were 10 year cumulative incidence of ipsilateral invasive breast cancer and ipsilateral DCIS estimated in relation to DCIS size and margin status, and adjusted hazard ratios and 95% confidence intervals, estimated using multivariable Cox proportional hazards analyses with multiple imputed data Results The 10 year cumulative incidence of ipsilateral invasive breast cancer was 3.2%. In women who underwent breast conserving surgery with or without radiotherapy, only adjusted risks for ipsilateral DCIS were significantly increased for larger DCIS (20-49 mm) compared with DCIS <20 mm (hazard ratio 1.38, 95% confidence interval 1.11 to 1.72). Risks for both ipsilateral invasive breast cancer and ipsilateral DCIS were significantly higher with involved compared with clear margins (invasive breast cancer 1.40, 1.07 to 1.83; DCIS 1.39, 1.04 to 1.87). Use of adjuvant endocrine treatment was not significantly associated with a lower risk of ipsilateral invasive breast cancer compared to treatment with breast conserving surgery only (0.86, 0.62 to 1.21). In women who received breast conserving treatment with or without radiotherapy, higher DCIS grade was not significantly associated with ipsilateral invasive breast cancer, only with a higher risk of ipsilateral DCIS (grade 1: 1.42, 1.08 to 1.87; grade 3: 2.17, 1.66 to 2.83). Higher age at diagnosis was associated with lower risk ... |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| العلاقة: | http://www.bmj.com/cgi/content/short/383/oct30_1/e076022Test; http://dx.doi.org/10.1136/bmj-2023-076022Test |
| DOI: | 10.1136/bmj-2023-076022 |
| الإتاحة: | https://doi.org/10.1136/bmj-2023-076022Test http://www.bmj.com/cgi/content/short/383/oct30_1/e076022Test |
| حقوق: | Copyright (C) 2023, BMJ Publishing Group Ltd |
| رقم الانضمام: | edsbas.84EC8021 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/bmj-2023-076022 |
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