Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project

on behalf of the Sloane Project Steering Committee, Abeer M. Shaaban, Bridget Hilton, Karen Baker, Elena Provenzano, Shan Cheung, Matthew G. Wallis, Elinor Sawyer, Jeremy S. Thomas, Andrew M. Hanby, Sarah E. Pinder, Alastair M. Thompson

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3 Citations (Scopus)

Abstract

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.

Original languageEnglish
JournalBritish Journal of Cancer
DOIs
Publication statusPublished - 17 Nov 2020

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