title: Characteristics of second breast events among women treated with breast-conserving surgery for DCIS in the community.
abstract: We examined the clinical/pathologic features of ipsilateral second breast cancers (IP-SBCs) following breast-conserving surgery (BCS) for DCIS among community-treated patients and ascertained the degree of correlation between the features of index DCIS and IP-SBC events. From a Cancer Research Network cohort of DCIS patients diagnosed 1990-2001 and treated with BCS, we identified women who subsequently developed an ipsilateral DCIS or invasive breast cancer. All index DCIS tumors underwent expert pathology review. Pathologic characteristics of IP-SBCs were abstracted from available medical records. Logistic regression was used to examine associations between pathologic characteristics and identify factors associated with invasive versus non-invasive IP-SBC. Of 1969 DCIS patients, 182 developed an IP-SBC within a median of 38 months (range 6-160). IP-SBCs were slightly more commonly non-invasive (53 %) versus invasive (47 %). Of invasive IP-SBCs, 31 % were high grade, 67 % were <20 mm, 74 % were estrogen receptor positive, 7 % were HER2 positive, and 16 % were node positive. Of non-invasive IP-SBCs, 33 % were high grade. Comparing index DCIS and IP-SBC specimens, there was moderate-high correlation for HR status and grade. Among patients with IP-SBCs, those who were younger and whose index DCIS tumors were HR negative had shorter intervals (within 3 years) between index and IP-SBC diagnoses. No index DCIS feature was statistically significantly associated with an IP-SBC that was invasive versus non-invasive. Understanding the characteristics of SBCs and identifying correlations between these and index DCIS events could influence treatment choices for DCIS, and may help patients and providers develop treatment paradigms for SBCs.
authors: Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215-5450, USA. michael_hassett@dfci.harvard.edu.|Harvard Medical School, Boston, MA, USA. michael_hassett@dfci.harvard.edu.
authors: Michael J
authors: MJ
authors: Hassett
authors: Department of Surgery, Brigham & Women's Hospital, Boston, MA, USA. wjiang3@partners.org.
authors: Wei
authors: W
authors: Jiang
authors: Division of Research, Kaiser Permanente, Oakland, CA, USA. laurel.habel@kp.org.
authors: Laurel A
authors: LA
authors: Habel
authors: Department of Population Medicine, Harvard Medical School, Boston, MA, USA. larissa_nekhlyudov@harvardpilgrim.org.|Department of Medicine, Harvard Vanguard Medical Associates, Boston, MA, USA. larissa_nekhlyudov@harvardpilgrim.org.
authors: Larissa
authors: L
authors: Nekhlyudov
authors: Division of Research, Kaiser Permanente, Oakland, CA, USA. ninah.s.achacoso@nsmtp.kp.org.
authors: Ninah
authors: N
authors: Achacoso
authors: Division of Research, Kaiser Permanente, Oakland, CA, USA. luana.acton@kp.org.
authors: Luana
authors: L
authors: Acton
authors: Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA. sschnitt@caregroup.harvard.edu.
authors: Stuart J
authors: SJ
authors: Schnitt
authors: Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215-5450, USA. deb_schrag@dfci.harvard.edu.|Harvard Medical School, Boston, MA, USA. deb_schrag@dfci.harvard.edu.
authors: Deb
authors: D
authors: Schrag
authors: Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. rpunglia@lroc.harvard.edu.|Harvard Medical School, Boston, MA, USA. rpunglia@lroc.harvard.edu.
authors: Rinaa S
authors: RS
authors: Punglia
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D011379:Prognosis; D018570:Risk Assessment
keywords: Breast cancer; DCIS; Grade; Hormone receptor; Recurrence; Second breast cancer