title: Predictors for local invasive recurrence of ductal carcinoma in situ of the breast: a meta-analysis.
abstract: The introduction of mammographic screening has considerably increased the detection rate of ductal carcinoma in situ (DCIS), which has a high probability of recurrence. We carried out a meta-analysis to evaluate the predictive factors including biomarkers, tumor characteristics, and modes of detection on the risk of local invasive recurrence (LIR) following DCIS. Searches were performed in PubMed and EMBASE up to 8 July 2014. Risk estimates (hazard ratios, odds ratios, and relative risks) and their 95% confidence intervals (CIs) were extracted to calculate the strength of the associations between predictive factors and the risk of LIR after treatment of DCIS. STATA 12.0 was used to combine results in this meta-analysis. A total of 18 articles were included in the analysis. Pooled risk estimates and 95% CIs were 1.36 (1.04-1.69) for the positive margin, 1.38 (1.12-1.63) for the nonscreening detection method, 1.04 (0.84-1.24) for high nuclear grade 1, 1.32 (0.98-1.66) for intermediate nuclear grade 2, 1.18 (0.98-1.37) for comedonecrosis, 1.00 (0.92-1.08) for large tumor size, 1.34 (0.82-1.87) for multifocality, 0.74 (0.36-1.12) for estrogen receptor-positive tumors, 0.89 (0.47-1.31) for progesterone receptor-positive tumors, and 1.25 (0.7-1.81) for HER2/neu-positive tumors. Positive margin and non-screening-detected cancers were associated with a higher risk of LIR following DCIS. These predictive factors, after further validation, could be considered to tailor treatment for individual patients.
authors.affiliation: Department of Epidemiology and Biostatistics, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center of Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China.
authors.forename: Xining
authors.initials: X
authors.lastname: Zhang
authors.forename: Hongji
authors.initials: H
authors.lastname: Dai
authors.forename: Ben
authors.initials: B
authors.lastname: Liu
authors.forename: Fengju
authors.initials: F
authors.lastname: Song
authors.forename: Kexin
authors.initials: K
authors.lastname: Chen
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000378:metabolism; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human