title: Impact of Histopathological Factors, Patient History and Therapeutic Variables on Recurrence-free Survival after Ductal Carcinoma in Situ: 8-Year Follow-up and Questionnaire Survey.
abstract: Introduction:Ductal carcinoma in situ (DCIS) is a premalignant lesion of the glandular component of the breast and a precursor lesion of invasive breast cancer. In recent decades the incidence of DCIS has risen continuously, mainly because of more extensive screening and more advanced diagnostic procedures. There is an increasing need for evidence-based treatment guidelines which will protect patients as far as possible from recurrence or invasive cancer but also from overtreatment. This retrospective single-center clinical trial analyzed recurrence-free survival times, rates of invasive and non-invasive events, and the impact of patient history, histopathological variables and therapeutic factors on recurrence-free survival times.Material and Methods:A total of 200 patients who underwent surgery between 2000 and 2007 for pure DCIS were included in the study. As part of follow-up a questionnaire was sent to patients and their respective gynecologists.Results:In the follow-up period, 12.5 % (n = 25) of the 200 patients had recurrence (invasive or non-invasive event). Menopausal status, tumor grade and tumor size were significantly associated with recurrence. Low-grade DCIS was significantly more often hormone receptor-positive than high-grade DCIS. Patients who had postoperative radiotherapy significantly more often also received endocrine drug treatment. There was a significant association between younger patient age and drug treatment. The study found that in the investigated cohort, premenopausal women had a significantly shorter recurrence-free time compared to postmenopausal women.Conclusion:This paper summarizes the current literature on DCIS. There is a need for more prospective clinical trials to improve the prognosis of premenopausal women with large and hormone receptor-positive DCIS.
authors: Obstetrics and Gynecology, University Hospital Center Schleswig-Holstein, Campus Kiel, Kiel.
authors: M T
authors: MT
authors: van Mackelenbergh
authors: Obstetrics and Gynecology, University Hospital Center Schleswig-Holstein, Campus Kiel, Kiel.
authors: C M
authors: CM
authors: Lindner
authors: Obstetrics and Gynecology, University Hospital Center Schleswig-Holstein, Campus Kiel, Kiel.
authors: T
authors: T
authors: Heilmann
authors: Obstetrics and Gynecology, University Hospital Center Schleswig-Holstein, Campus Kiel, Kiel.
authors: I
authors: I
authors: Alkatout
authors: Obstetrics and Gynecology, University Hospital Center Schleswig-Holstein, Campus Kiel, Kiel.
authors: M
authors: M
authors: Elessawy
authors: Obstetrics and Gynecology, University Hospital Center Schleswig-Holstein, Campus Kiel, Kiel.
authors: C
authors: C
authors: Mundhenke
authors: Obstetrics and Gynecology, University Hospital Center Schleswig-Holstein, Campus Kiel, Kiel.
authors: N
authors: N
authors: Maass
authors: Obstetrics and Gynecology, University Hospital Center Schleswig-Holstein, Campus Kiel, Kiel.
authors: C
authors: C
authors: Schem
keywords: age; hormone receptor-positive high-grade DCIS; radiation; tumor size