ER+ DCIS tied to higher risk for contralateral breast cancer

  • Stout NK & al.
  • Breast Cancer Res Treat
  • 26 Jun 2018

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Estrogen receptor (ER)-positive ductal carcinoma in situ (DCIS) is associated with higher risk for contralateral breast cancer (CBC) than ER− DCIS in the Surveillance, Epidemiology, and End Results (SEER) analysis.

Why this matters

  • Most cases of DCIS are ER+, yet few patients receive hormonal therapy.

Study design

  • Retrospective cohort study of 46,007 women with DCIS diagnosed between 1990 and 2002 in the SEER database.
  • Multivariable competing risk regression was used to identify predictors of time from index DCIS to CBC (in situ or invasive).
  • Funding: Patient-Centered Outcomes Research Institute.

Key results

  • Most women with DCIS were white (82%); average age was 58.4 years.
  • 75% of patients had ER+ DCIS.
  • Median follow-up time was 14 years, 2 months.
  • ER− DCIS was 40% less likely to have CBC than ER+ DCIS (HR, 0.6; 95% CI, 0.5-0.8).
  • At 10 years, the model estimated that 5.3% (95% CI, 4.8%-5.9%) of ER+ DCIS will have CBC compared with 3.4% (95% CI, 2.7%-4%) of ER− DCIS, after adjusting for other factors.

Limitations

  • Possible underascertainment of CBC.

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