Six risk factors tied to breast cancer recurrence after DCIS

  • Visser LL & al.
  • Cancer Epidemiol Biomarkers Prev
  • 1 May 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Meta-analysis identified 6 factors associated with the risk for subsequent ipsilateral-invasive breast cancer (iIBC) in patients with ductal carcinoma in situ (DCIS).

Why this matters

  • These prognostic factors will help identify patients at higher risk for invasive breast cancer recurrence and avoid overtreatment in low-risk disease.

Study design

  • Meta-analysis of 40 studies including patients with DCIS (n=52 to 37,692) identified after a search on PubMed until 2018.
  • Funding: Cancer Research UK; Dutch Cancer Society.

Key results

  • Mean follow-up time ranged from 3.2 to 15.8 years.
  • Factors associated with the risk for subsequent iIBC were:
    • African-American race (pooled estimate [ES], 1.43; 95% CI, 1.15-1.79),
    • premenopausal status (ES, 1.59; 95% CI, 1.20-2.11),
    • detection by palpation (ES, 1.84; 95% CI, 1.47-2.29),
    • positive margins (ES, 1.63; 95% CI, 1.14-2.32),
    • high histologic grade (poorly differentiated; ES, 1.36; 95% CI, 1.04-1.77), and
    • high p16 expression (ES, 1.51; 95% CI, 1.04-2.19).
  • Highest risk of bias was attributed to confounding measurement and poorly defined study groups.

Limitations

  • Meta-analyses were not performed for the factors: age at diagnosis, DCIS architecture, lesion size, and year of DCIS diagnosis.

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