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- Title
Long-term risk of subsequent ipsilateral lesions after surgery with or without radiotherapy for ductal carcinoma in situ of the breast.
- Authors
van Seijen, Maartje; Lips, Esther H.; Fu, Liping; Giardiello, Daniele; van Duijnhoven, Frederieke; de Munck, Linda; Elshof, Lotte E.; Thompson, Alastair; Sawyer, Elinor; Ryser, Marc D.; Hwang, E. Shelley; Schmidt, Marjanka K.; Elkhuizen, Paula H. M.; Wesseling, Jelle; Schaapveld, Michael; Grand Challenge PRECISION Consortium
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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)).<bold>Conclusion: </bold>RT is associated with lower iDCIS and iIBC risk up to 10 years after BCS, but this effect wanes thereafter.
- Subjects
NETHERLANDS; ADENOCARCINOMA; RESEARCH; RESEARCH methodology; DISEASE incidence; EVALUATION research; COMPARATIVE studies; SECONDARY primary cancer; IMPACT of Event Scale; RESEARCH funding; BREAST tumors; LONGITUDINAL method
- Publication
British Journal of Cancer, 2021, Vol 125, Issue 10, p1443
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-021-01496-6