Management of women with ductal carcinoma in situ of the breast: a population-based study.
Details
Serval ID
serval:BIB_952ACF49362A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Management of women with ductal carcinoma in situ of the breast: a population-based study.
Journal
Annals of oncology
ISSN
0923-7534 (Print)
ISSN-L
0923-7534
Publication state
Published
Issued date
08/2002
Peer-reviewed
Oui
Volume
13
Number
8
Pages
1236-1245
Language
english
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Increasing incidence of ductal carcinoma in situ (DCIS) confronts patients and clinicians with optimal treatment decisions. This multidisciplinary study investigates therapeutic modalities of DCIS in daily practice and provides recommendations on how to increase quality of care.
All women (n = 116) with unilateral DCIS recorded in the Geneva Cancer Registry from 1995 to 1999 were considered. Information concerned patient and tumor characteristics, treatment and outcome. Factors linked to therapy were determined using a case-control approach. Cases were women with treatment of interest and controls other women on the study.
Most DCIS cases (62%) were discovered by mammography screening. Ninety (78%) women had breast-conserving surgery (BCS), 18 (16%) mastectomy and seven (6%) bilateral mastectomy. Eight (7%) patients had tumor-positive margins, 18 (16%) lymph node dissection and two (1.7%) chemotherapy. Twenty-five per cent of women with BCS had no radiotherapy, three had radiotherapy after mastectomy. Less than 50% underwent breast reconstruction after mastectomy. Method of discovery, multifocality, tumor localization, size and differentiation were linked to the use of BCS or lymph node dissection.
Because of important disparities in DCIS management, recommendations are made to increase quality of care, in particular to prevent axillary dissection or bilateral mastectomy and to increase the use of radiotherapy after BCS.
All women (n = 116) with unilateral DCIS recorded in the Geneva Cancer Registry from 1995 to 1999 were considered. Information concerned patient and tumor characteristics, treatment and outcome. Factors linked to therapy were determined using a case-control approach. Cases were women with treatment of interest and controls other women on the study.
Most DCIS cases (62%) were discovered by mammography screening. Ninety (78%) women had breast-conserving surgery (BCS), 18 (16%) mastectomy and seven (6%) bilateral mastectomy. Eight (7%) patients had tumor-positive margins, 18 (16%) lymph node dissection and two (1.7%) chemotherapy. Twenty-five per cent of women with BCS had no radiotherapy, three had radiotherapy after mastectomy. Less than 50% underwent breast reconstruction after mastectomy. Method of discovery, multifocality, tumor localization, size and differentiation were linked to the use of BCS or lymph node dissection.
Because of important disparities in DCIS management, recommendations are made to increase quality of care, in particular to prevent axillary dissection or bilateral mastectomy and to increase the use of radiotherapy after BCS.
Keywords
Adult, Aged, Aged, 80 and over, Breast Neoplasms/diagnosis, Breast Neoplasms/therapy, Carcinoma, Intraductal, Noninfiltrating/diagnosis, Carcinoma, Intraductal, Noninfiltrating/therapy, Case-Control Studies, Cell Differentiation, Combined Modality Therapy, Disease Progression, Female, Humans, Lymph Node Excision, Mammography, Mastectomy, Segmental, Middle Aged, Neoplasm Recurrence, Local, Population Surveillance, Quality of Life, Registries, Risk Factors, Socioeconomic Factors
Pubmed
Web of science
Open Access
Yes
Create date
14/12/2016 10:22
Last modification date
06/08/2024 14:55