M C van Maaren1, M Lagendijk2, M M A Tilanus-Linthorst2, L de Munck3, R M Pijnappel4, M K Schmidt5, J Wesseling6, L B Koppert2, S Siesling7. 1. Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands; Department of Health Technology & Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands. Electronic address: m.vanmaaren@iknl.nl. 2. Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. 3. Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen Groningen, the Netherlands. 4. Department of Imaging, University Medical Centre Utrecht, Utrecht University, The Netherlands. 5. Department of Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands. 6. Department of Molecular Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands. 7. Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands; Department of Health Technology & Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
Abstract
BACKGROUND: The incidence of ductal carcinoma in situ (DCIS) has drastically increased over the past decades. Because DCIS is resected after diagnosis similar to invasive breast cancer, the natural cause and behaviour of DCIS is not well known. We aimed to determine breast cancer-specific survival (BCSS) and overall survival (OS) according to grade in DCIS patients after surgical treatment in the Netherlands. PATIENTS AND METHODS: All DCIS patients diagnosed between 1999 and 2012 were selected from the Netherlands Cancer Registry. The cause of death was obtained from 'Statistics Netherlands'. BCSS and OS were estimated using multivariable Cox regression in the entire cohort and stratified for grades. RESULTS: In total, 12,256 patients were included, of whom 1509 (12.3%) presented with grade I, 3675 (30.0%) with grade II, 6064 (49.5%) with grade III and 1008 (8.2%) with an unknown grade. During a median follow-up of 7.8 years, 1138 (9.3%) deaths were observed, and 179 (1.5%) were breast cancer-related. Of these, 10 patients had grade I; 46 grade II; 95 grade III and 28 an unknown grade. After adjustment for confounding, grade II and III were related to worse BCSS than grade I with hazard ratios of 1.92 (95% confidence interval [CI]: 0.97-3.81) and 2.14 (95% CI: 1.11-4.12), respectively. No association between grades and OS was observed. CONCLUSION: BCSS and OS in DCIS patients were excellent. Because superior rates were observed for low-grade DCIS, it seems justified to investigate whether active surveillance may be a balanced alternative for conventional surgical treatment.
BACKGROUND: The incidence of ductal carcinoma in situ (DCIS) has drastically increased over the past decades. Because DCIS is resected after diagnosis similar to invasive breast cancer, the natural cause and behaviour of DCIS is not well known. We aimed to determine breast cancer-specific survival (BCSS) and overall survival (OS) according to grade in DCIS patients after surgical treatment in the Netherlands. PATIENTS AND METHODS: All DCIS patients diagnosed between 1999 and 2012 were selected from the Netherlands Cancer Registry. The cause of death was obtained from 'Statistics Netherlands'. BCSS and OS were estimated using multivariable Cox regression in the entire cohort and stratified for grades. RESULTS: In total, 12,256 patients were included, of whom 1509 (12.3%) presented with grade I, 3675 (30.0%) with grade II, 6064 (49.5%) with grade III and 1008 (8.2%) with an unknown grade. During a median follow-up of 7.8 years, 1138 (9.3%) deaths were observed, and 179 (1.5%) were breast cancer-related. Of these, 10 patients had grade I; 46 grade II; 95 grade III and 28 an unknown grade. After adjustment for confounding, grade II and III were related to worse BCSS than grade I with hazard ratios of 1.92 (95% confidence interval [CI]: 0.97-3.81) and 2.14 (95% CI: 1.11-4.12), respectively. No association between grades and OS was observed. CONCLUSION: BCSS and OS in DCIS patients were excellent. Because superior rates were observed for low-grade DCIS, it seems justified to investigate whether active surveillance may be a balanced alternative for conventional surgical treatment.
Authors: Serdar Altinay; Laurent Arnould; Noella Bletard; Cecile Colpaert; Franceska Dedeurwaerdere; Benjamin Dessauvagie; Valérie Duwel; Giuseppe Floris; Stephen Fox; Clara Gerosa; Shabnam Jaffer; Eline Kurpershoek; Magali Lacroix-Triki; Andoni Laka; Kathleen Lambein; Gaëtan Marie MacGrogan; Caterina Marchió; Dolores Martin Martinez; Sharon Nofech-Mozes; Dieter Peeters; Alberto Ravarino; Emily Reisenbichler; Erika Resetkova; Souzan Sanati; Anne-Marie Schelfhout; Vera Schelfhout; Abeer M Shaaban; Renata Sinke; Claudia Maria Stanciu-Pop; Claudia Stobbe; Carolien H M van Deurzen; Koen Van de Vijver; Anne-Sophie Van Rompuy; Stephanie Verschuere; Anne Vincent-Salomon; Hannah Wen; Hélène Dano; Caroline Bouzin; Christine Galant; Mieke R Van Bockstal Journal: Mod Pathol Date: 2019-09-18 Impact factor: 7.842
Authors: Mieke R Van Bockstal; Marie C Agahozo; Linetta B Koppert; Carolien H M van Deurzen Journal: Int J Cancer Date: 2019-05-08 Impact factor: 7.396
Authors: Jacky D Luiten; Ernest J T Luiten; Maurice J C van der Sangen; Willem Vreuls; Lucien E M Duijm; Vivianne C G Tjan-Heijnen; Adri C Voogd Journal: Breast Cancer Res Treat Date: 2021-01-01 Impact factor: 4.872