TY - JOUR
T1 - Pathological features of 11337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events – results from the UK Sloane project
T2 - DCIS pathology and outcome in the Sloane Project
AU - on behalf of the Sloane Project Steering Committee
AU - Shaaban, Abeer M.
AU - Hilton, Bridget
AU - Clements, Karen
AU - Provenzano, Elena
AU - Cheung, Shan
AU - Wallis, Matthew G.
AU - Sawyer, Elinor
AU - Thomas, Jeremy S.
AU - Hanby, Andrew M.
AU - Pinder, Sarah E.
AU - Thompson, Alastair M.
PY - 2020/11/17
Y1 - 2020/11/17
N2 - Background: The Sloane audit compares screen-detected ductal carcinoma in situ (DCIS) pathology with subsequent management and outcomes. Methods: This was a national, prospective cohort study of DCIS diagnosed during 2003–2012. Results: Among 11,337 patients, 7204 (64%) had high-grade DCIS. Over time, the proportion of high-grade disease increased (from 60 to 65%), low-grade DCIS decreased (from 10 to 6%) and mean size increased (from 21.4 to 24.1 mm). Mastectomy was more common for high-grade (36%) than for low-grade DCIS (15%). Few (6%) patients treated with breast-conserving surgery (BCS) had a surgical margin <1 mm. Of the 9191 women diagnosed in England (median follow-up 9.4 years), 7% developed DCIS or invasive malignancy in the ipsilateral and 5% in the contralateral breast. The commonest ipsilateral event was invasive carcinoma (n = 413), median time 62 months, followed by DCIS (n = 225), at median 37 months. Radiotherapy (RT) was most protective against recurrence for high-grade DCIS (3.2% for high-grade DCIS with RT compared to 6.9% without, compared with 2.3 and 3.0%, respectively, for low/intermediate-grade DCIS). Ipsilateral DCIS events lessened after 5 years, while the risk of ipsilateral invasive cancer remained consistent to beyond 10 years. Conclusion: DCIS pathology informs patient management and highlights the need for prolonged follow-up of screen-detected DCIS.
AB - Background: The Sloane audit compares screen-detected ductal carcinoma in situ (DCIS) pathology with subsequent management and outcomes. Methods: This was a national, prospective cohort study of DCIS diagnosed during 2003–2012. Results: Among 11,337 patients, 7204 (64%) had high-grade DCIS. Over time, the proportion of high-grade disease increased (from 60 to 65%), low-grade DCIS decreased (from 10 to 6%) and mean size increased (from 21.4 to 24.1 mm). Mastectomy was more common for high-grade (36%) than for low-grade DCIS (15%). Few (6%) patients treated with breast-conserving surgery (BCS) had a surgical margin <1 mm. Of the 9191 women diagnosed in England (median follow-up 9.4 years), 7% developed DCIS or invasive malignancy in the ipsilateral and 5% in the contralateral breast. The commonest ipsilateral event was invasive carcinoma (n = 413), median time 62 months, followed by DCIS (n = 225), at median 37 months. Radiotherapy (RT) was most protective against recurrence for high-grade DCIS (3.2% for high-grade DCIS with RT compared to 6.9% without, compared with 2.3 and 3.0%, respectively, for low/intermediate-grade DCIS). Ipsilateral DCIS events lessened after 5 years, while the risk of ipsilateral invasive cancer remained consistent to beyond 10 years. Conclusion: DCIS pathology informs patient management and highlights the need for prolonged follow-up of screen-detected DCIS.
UR - http://www.scopus.com/inward/record.url?scp=85096066870&partnerID=8YFLogxK
U2 - 10.1038/s41416-020-01152-5
DO - 10.1038/s41416-020-01152-5
M3 - Article
AN - SCOPUS:85096066870
SN - 0007-0920
VL - 124
SP - 1009
EP - 1017
JO - BJC: British Journal of Cancer
JF - BJC: British Journal of Cancer
ER -
