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DCIS with Microinvasion: Is It In Situ or Invasive Disease?

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Champion, CD; Ren, Y; Thomas, SM; Fayanju, OM; Rosenberger, LH; Greenup, RA; Menendez, CS; Hwang, ES; Plichta, JK
Published in: Ann Surg Oncol
October 2019

BACKGROUND: Ductal carcinoma in situ (DCIS) with microinvasion (DCISM) can be challenging in balancing the risks of overtreatment versus undertreatment. We compared DCISM, pure DCIS, and small volume (T1a) invasive ductal carcinoma (IDC) as related to histopathology, treatment patterns, and survival outcomes. METHODS: Women ages 18-90 years who underwent breast surgery for DCIS, DCISM, or T1a IDC were selected from the SEER Database (2004-2015). Multivariate logistic regression and Cox proportional hazards models were used to estimate the association of diagnosis with treatment and survival, respectively. RESULTS: A total of 134,569 women were identified: 3.2% DCISM, 70.9% DCIS, and 25.9% with T1a IDC. Compared with invasive disease, DCISM was less likely to be ER+ or PR+ and more likely to be HER2+. After adjustment, DCIS and invasive patients were less likely to undergo mastectomy than DCISM patients (DCIS: OR 0.53, 95% CI 0.49-0.56; invasive: OR 0.86, CI 0.81-0.92). For those undergoing lumpectomy, the likelihood of receiving radiation was similar for DCISM and invasive patients but lower for DCIS patients (OR 0.57, CI 0.52-0.63). After adjustment, breast-cancer-specific survival was significantly different between DCISM and the other two groups (DCIS: HR 0.59, CI 0.43-0.8; invasive: HR 1.43, CI 1.04-1.96). However, overall survival was not significantly different between DCISM and invasive disease, whereas patients with DCIS had improved OS (HR 0.83, CI 0.75-0.93). CONCLUSIONS: Although DCISM is a distinct entity, current treatment patterns and prognosis are comparable to those with small volume IDC. These findings may help providers counsel patients and determine appropriate treatment plans.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

October 2019

Volume

26

Issue

10

Start / End Page

3124 / 3132

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Invasiveness
  • Middle Aged
  • Humans
  • Follow-Up Studies
  • Female
  • Combined Modality Therapy
 

Citation

APA
Chicago
ICMJE
MLA
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Champion, C. D., Ren, Y., Thomas, S. M., Fayanju, O. M., Rosenberger, L. H., Greenup, R. A., … Plichta, J. K. (2019). DCIS with Microinvasion: Is It In Situ or Invasive Disease? In Ann Surg Oncol (Vol. 26, pp. 3124–3132). United States. https://doi.org/10.1245/s10434-019-07556-9
Champion, Cosette D., Yi Ren, Samantha M. Thomas, Oluwadamilola M. Fayanju, Laura H. Rosenberger, Rachel A. Greenup, Carolyn S. Menendez, E Shelley Hwang, and Jennifer K. Plichta. “DCIS with Microinvasion: Is It In Situ or Invasive Disease?” In Ann Surg Oncol, 26:3124–32, 2019. https://doi.org/10.1245/s10434-019-07556-9.
Champion CD, Ren Y, Thomas SM, Fayanju OM, Rosenberger LH, Greenup RA, et al. DCIS with Microinvasion: Is It In Situ or Invasive Disease? In: Ann Surg Oncol. 2019. p. 3124–32.
Champion, Cosette D., et al. “DCIS with Microinvasion: Is It In Situ or Invasive Disease?Ann Surg Oncol, vol. 26, no. 10, 2019, pp. 3124–32. Pubmed, doi:10.1245/s10434-019-07556-9.
Champion CD, Ren Y, Thomas SM, Fayanju OM, Rosenberger LH, Greenup RA, Menendez CS, Hwang ES, Plichta JK. DCIS with Microinvasion: Is It In Situ or Invasive Disease? Ann Surg Oncol. 2019. p. 3124–3132.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

October 2019

Volume

26

Issue

10

Start / End Page

3124 / 3132

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Invasiveness
  • Middle Aged
  • Humans
  • Follow-Up Studies
  • Female
  • Combined Modality Therapy