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