title: Clinicopathological predictive factors for ipsilateral and contralateral events following initial surgery to treat ductal carcinoma in situ.
abstract: BACKGROUND
  Ipsilateral breast tumor recurrence (IBTR) after partial breast resection and contralateral breast tumor recurrence (CBTR) have been shown to occur relatively frequently in patients with ductal carcinoma in situ (DCIS). However, there is only limited data from Japanese institutes to support this.
  
  
  METHODS
  Of 301 consecutive DCIS patients, 179 patients underwent a mastectomy, and the other 122 underwent partial resection in the National Cancer Center Hospital, Tokyo, with a median follow-up period of 2,106 days. We reviewed clinicopathological parameters including age, menopausal status, body mass index, family history (FH) of breast cancer, tumor size, histological subtype, nuclear grade (NG), hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status, treatment, and the surgical margin status of partially resected specimens. The risk associated with each of these parameters for IBTR in 122 patients who underwent partial resections, and for CBTR in a total of 301 patients were calculated using Cox proportional hazard general linear models.
  
  
  RESULTS
  Of the 122 patients who underwent partial breast resection, IBTR occurred in 7 (5.7%). The risk of IBTR was higher or tended to be higher in younger patients or those with lower NG tumors, but did not change significantly with respect to margin status or irradiation. Amongst the entire cohort of 301 patients, CBTR occurred in 18 cases (6.0%). CBTR occurred significantly more frequently in patients with a FH of breast cancer and with HR+/HER2- subtype tumors by univariate analyses, and tumor subtype was an independent risk factor for CBTR by multivariate analysis.
  
  
  CONCLUSIONS
  The local recurrence rate was low following partial resection of DCIS. Younger age was a risk factor for IBTR, whereas the HR+/HER2- tumor subtype and a FH of breast cancer were risk factors for CBTR.
authors: Department of Breast and Endocrine Surgery, Toranomon Hospital, Tokyo, Japan.|Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.|Surgical Oncology Division, Tokyo Medical and Dental University, Tokyo, Japan.
authors: Nobuko
authors: N
authors: Tamura
authors: Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan. hstsuda@gmail.com.|Department of Basic Pathology, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama, 359-8513, Japan. hstsuda@gmail.com.
authors: Hitoshi
authors: H
authors: Tsuda
authors: Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.
authors: Masayuki
authors: M
authors: Yoshida
authors: Breast Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Takashi
authors: T
authors: Hojo
authors: Division of breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan.
authors: Sadako
authors: S
authors: Akashi-Tanaka
authors: Breast Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Takayuki
authors: T
authors: Kinoshita
authors: Surgical Oncology Division, Tokyo Medical and Dental University, Tokyo, Japan.
authors: Kenichi
authors: K
authors: Sugihara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Contralateral breast tumor recurrence (CBTR); Ductal carcinoma in situ (DCIS); Histological subtype; Intrinsic subtype; Ispilateral breast tumor recurrence (IBTR); Nuclear grade