Characteristics of second breast events among women treated with breast-conserving surgery for DCIS in the community

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• 作者：Michael J. Hassett ; Wei Jiang ; Laurel A. Habel…
• 关键词：Breast cancer ; DCIS ; Recurrence ; Second breast cancer ; Hormone receptor ; Grade
• 刊名：Breast Cancer Research and Treatment
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：155
• 期：3
• 页码：541-549
• 全文大小：429 KB
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• 作者单位：Michael J. Hassett (1) (8)
  Wei Jiang (2)
  Laurel A. Habel (3)
  Larissa Nekhlyudov (4) (5)
  Ninah Achacoso (3)
  Luana Acton (3)
  Stuart J. Schnitt (6)
  Deb Schrag (1) (8)
  Rinaa S. Punglia (7) (8)
  
  1. Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215-5450, USA
  8. Harvard Medical School, Boston, MA, USA
  2. Department of Surgery, Brigham & Women’s Hospital, Boston, MA, USA
  3. Division of Research, Kaiser Permanente, Oakland, CA, USA
  4. Department of Population Medicine, Harvard Medical School, Boston, MA, USA
  5. Department of Medicine, Harvard Vanguard Medical Associates, Boston, MA, USA
  6. Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
  7. Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  
• 出版者：Springer Netherlands
• ISSN：1573-7217

文摘

We examined the clinical/pathologic features of ipsilateral second breast cancers (IP-SBCs) following breast-conserving surgery (BCS) for DCIS among community-treated patients and ascertained the degree of correlation between the features of index DCIS and IP-SBC events. From a Cancer Research Network cohort of DCIS patients diagnosed 1990–2001 and treated with BCS, we identified women who subsequently developed an ipsilateral DCIS or invasive breast cancer. All index DCIS tumors underwent expert pathology review. Pathologic characteristics of IP-SBCs were abstracted from available medical records. Logistic regression was used to examine associations between pathologic characteristics and identify factors associated with invasive versus non-invasive IP-SBC. Of 1969 DCIS patients, 182 developed an IP-SBC within a median of 38 months (range 6–160). IP-SBCs were slightly more commonly non-invasive (53 %) versus invasive (47 %). Of invasive IP-SBCs, 31 % were high grade, 67 % were <20 mm, 74 % were estrogen receptor positive, 7 % were HER2 positive, and 16 % were node positive. Of non-invasive IP-SBCs, 33 % were high grade. Comparing index DCIS and IP-SBC specimens, there was moderate–high correlation for HR status and grade. Among patients with IP-SBCs, those who were younger and whose index DCIS tumors were HR negative had shorter intervals (within 3 years) between index and IP-SBC diagnoses. No index DCIS feature was statistically significantly associated with an IP-SBC that was invasive versus non-invasive. Understanding the characteristics of SBCs and identifying correlations between these and index DCIS events could influence treatment choices for DCIS, and may help patients and providers develop treatment paradigms for SBCs.