Niwińska Anna, Kunkiel Michał
Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgen 5 Str., 02-784 Warsaw, Poland.
Cancers (Basel). 2022 Jan 28;14(3):669. doi: 10.3390/cancers14030669.
To assess the outcomes of 737 consecutive patients with DCIS, with particular attention to the type of recurrences, other malignancies and causes of deaths. A retrospective analysis of 737 consecutive DCIS patients treated in one institution in the years 1996-2011 was carried out. The cumulative recurrence risk, DFS, OS depending on the method of treatment (mastectomy, breast-conserving treatment (BCT), breast-conserving surgery (BCS)) and cause of death were assessed. Sixty-six recurrences (42% DCIS, 58% invasive) were reported: 61 in the breast and 5 outside the breast. The cumulative recurrence risk after a 15-year observation after mastectomy, BCT and BCS was 3.2%, 19.5% and 31.2%, respectively ( < 0.001). The 15-year DFS after mastectomy, BCT and BCS was 72%, 65% and 48%, respectively ( < 0.001). The 15-year OS after mastectomy, BCT and BCS was 75%, 83% and 70%, respectively ( = 0.329). Deaths due to DCIS progression were reported in four (0.5%) of the overall patients and in 10.5% of patients with invasive recurrences. The majority of deaths were linked to the age of the patients or other diseases, including other neoplasms, but not DCIS. The highest number of recurrences was reported in patients after BCS, despite the fact that it was the lowest-risk group. In total, 79% of local recurrences were true recurrences and 58% were invasive recurrences. Local recurrences were effectively treated without an influence on the OS. The percentage of deaths due to DCIS was low and mainly concerned patients with locoregional and distant failure.
为评估737例连续的导管原位癌（DCIS）患者的预后，尤其关注复发类型、其他恶性肿瘤及死亡原因。对1996年至2011年在某一机构接受治疗的737例连续DCIS患者进行了回顾性分析。评估了根据治疗方法（乳房切除术、保乳治疗（BCT）、保乳手术（BCS））的累积复发风险、无病生存期（DFS）、总生存期（OS）及死亡原因。报告了66例复发（42%为DCIS，58%为浸润性）：61例在乳房内，5例在乳房外。乳房切除术后、BCT及BCS后15年观察期的累积复发风险分别为3.2%、19.5%和31.2%（P<0.001）。乳房切除术后、BCT及BCS后的15年DFS分别为72%、65%和48%（P<0.001）。乳房切除术后、BCT及BCS后的15年OS分别为75%、83%和70%（P = 0.329）。在全部患者中有4例（0.5%）因DCIS进展死亡，在浸润性复发患者中有10.5%因DCIS进展死亡。大多数死亡与患者年龄或其他疾病有关，包括其他肿瘤，但与DCIS无关。尽管BCS组是风险最低的组，但该组报告的复发数量最多。总体而言，79%的局部复发为真性复发，58%为浸润性复发。局部复发得到有效治疗，未对OS产生影响。因DCIS导致的死亡百分比很低，主要涉及局部区域和远处复发的患者。
