https://scholars.lib.ntu.edu.tw/handle/123456789/470163
標題: | Prognostic Significance of Clinicopathologic Features in Patients With Breast Ductal Carcinoma-in-Situ Who Received Breast-Conserving Surgery | 作者: | SUNG-HSIN KUO Chiao Lo YU-HSUAN CHEN HUANG-CHUN LIEN WEN-HUNG KUO Wang, Ming-Yang Lee, Yi-Hsuan CHIUN-SHENG HUANG |
關鍵字: | California/Van Nuys Prognostic Index;Clinicopathologic features;Disease free survival;Eastern Cooperative Oncology Group E5194;Ipsilateral breast tumor recurrence | 公開日期: | 十二月-2018 | 出版社: | Elsevier Inc. | 卷: | 18 | 期: | 6 | 起(迄)頁: | 441 | 來源出版物: | Clinical Breast Cancer | 摘要: | This study confirms that adjuvant breast irradiation reduces the risk of ipsilateral breast tumor recurrence (IBTR) in patients treated with breast-conserving surgery (BCS) for ductal carcinoma-in-situ. This study also shows that the risk of IBTR is associated with patient, tumor, and treatment characteristics such as age, tumor size, tumor grade, surgical margin, positive expression of estrogen receptor, and tamoxifen administration. There may be a group of patients with low risk of IBTR who could be treated with BCS alone. Purpose: To identify whether a certain group of breast ductal carcinoma-in-situ (DCIS) patients can be treated with breast-conserving surgery (BCS) alone; to analyze the clinicopathologic features of DCIS and tamoxifen administration in patients treated with BCS who developed ipsilateral breast tumor recurrence (IBTR). Patients and Methods: Data for 375 women with breast DCIS who underwent BCS at our institute between June 2003 and October 2010 were analyzed. The patients were divided into different categories according to the recurrence risk predicted using the California/Van Nuys Prognostic Index (USC/VNPI) score (4-6, 7-9, and 10-12), Eastern Cooperative Oncology Group (ECOG) E5194 criteria, or combined risk features with USC/VNPI score and ECOG E5194 criteria. The IBTR and disease-free survival (DFS) rates were calculated by the Kaplan-Meier method. The prognostic effects of age, tumor size, tumor grade, margin width, estrogen receptor status, USC/VNPI score, low-risk characteristics, and tamoxifen use were evaluated by log-rank tests. Results: Of the patients, 168 were treated with breast irradiation after BCS and 207 were not. The patients who were treated with radiotherapy (RT) tended to be younger (< 40 years), to have higher USC/VNPI scores (7-9), and to meet the ECOG E5194 non–cohort 1 criteria. The 7-year risk of IBTR was 6.2% (n = 11) in the patients who received irradiation and 9.0% (n = 22) in those who did not. DFS rates were better in the patients who underwent RT than in those who did not (93.3% vs. 88.5%, P =.056). Among the patients who underwent BCS alone, age ? 40 years, margin width > 10 mm, USC/VNPI scores 4-6, ECOG E5194 cohort 1 criteria, estrogen receptor–positive status, and tamoxifen use predicted lower IBTR and better DFS rates. In the multivariate analysis, combined low-risk characteristics (USC/VNPI scores 4-6 and meeting the ECOG E5194 cohort 1 criteria) were identified as an independent prognostic factor of lower IBTR (P =.028) and better DFS (P =.005). Conclusion: RT reduces the risk of IBTR after BCS for DCIS of the breast. Patients with combined low-risk characteristics (USC/VNPI scores 4-6 and meeting the ECOG E5194 cohort 1 criteria) may be adequately treated with BCS alone. ? 2018 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85046121586&doi=10.1016%2fj.clbc.2018.04.002&partnerID=40&md5=8453e9ad6f3573292a99c6901525f702 https://scholars.lib.ntu.edu.tw/handle/123456789/470163 |
ISSN: | 1526-8209 | DOI: | 10.1016/j.clbc.2018.04.002 | SDG/關鍵字: | tamoxifen; antineoplastic hormone agonists and antagonists; adjuvant radiotherapy; adult; age; Article; breast radiotherapy; California Van Nuys Prognostic Index score; cancer grading; cancer hormone therapy; cancer prognosis; cancer surgery; cancer survival; clinical feature; cohort analysis; disease free survival; estrogen receptor positive breast cancer; female; histopathology; human; intraductal carcinoma; major clinical study; overall survival; partial mastectomy; prognostic assessment; recurrence risk; surgical margin; survival prediction; survival rate; tumor recurrence; tumor volume; aged; breast tumor; epidemiology; follow up; incidence; intraductal carcinoma; middle aged; multimodality cancer therapy; Paget nipple disease; pathology; prognosis; Taiwan; very elderly; young adult; Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating; Cohort Studies; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Incidence; Mastectomy, Segmental; Middle Aged; Neoplasm Recurrence, Local; Prognosis; Radiotherapy, Adjuvant; Taiwan; Tamoxifen; Young Adult |
顯示於: | 病理學科所 |
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