title: Predictors of Recurrent Ductal Carcinoma In Situ after Breast-Conserving Surgery.
abstract: OBJECTIVE
  Local recurrence is a major concern in patients who have undergone surgery for ductal carcinoma in situ (DCIS). The present study assessed whether the expression levels of hormone receptors, human epidermal growth factor receptor 2 (HER2), and Ki-67, as well as resection margin status, tumor grade, age at diagnosis, and adjuvant hormonal therapy and radiotherapy (RT) are associated with recurrence in women with DCIS.
  
  
  METHODS
  In total, 111 patients with DCIS were included in the present study. The invasive and noninvasive recurrence events were recorded. The clinicopathological features; resection margins; administration of hormonal therapy and RT; expression statuses of estrogen receptor (ER), progesterone receptor (PR), and HER2; Ki-67 expression; and molecular subtypes were evaluated. Logistic regression analysis was performed to examine the risk factors for recurrence.
  
  
  RESULTS
  Recurrence was noted in 27 of 111 cases (24.3%). Involvement of resection margins, low tumor grade, high Ki-67 expression, and RT were independently associated with an increase in the recurrence rate (p<0.05, Pearson chi-square test). The recurrence rate was not significantly associated with patient age; ER, PR, and HER2 statuses; molecular subtype; and hormonal therapy.
  
  
  CONCLUSIONS
  The results of the present study suggested that the involvement of resection margins, low tumor grade, high Ki-67 index, and the absence of adjuvant RT were independently associated with increased recurrence in patients with DCIS. Future studies should be conducted in a larger cohort of patients to further improve the identification of patients at high-risk for DCIS recurrence.
authors.affiliation: Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors.forename: Jung Yeon
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors.forename: Kyeongmee
authors.initials: K
authors.lastname: Park
authors.affiliation: Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors.forename: Guhyun
authors.initials: G
authors.lastname: Kang
authors.affiliation: Department of Pathology, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors.forename: Hyun-Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors.forename: Geumhee
authors.initials: G
authors.lastname: Gwak
authors.affiliation: Department of Radiation Oncology, Inje University Sanggye Paik Hospital, Seoul, Korea.
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Shin
keywords: Breast; Carcinoma; Intraductal; Recurrence