Evidence map›Paper›PMID 20517310›Full record

ArticleBritish journal of cancer2010

A new pathological system for grading DCIS with improved prediction of local recurrence: results from the UKCCCR/ANZ DCIS trial.

S E Pinder, C Duggan, I O Ellis, J Cuzick, J F Forbes, H Bishop, I S Fentiman, W D George, UK Coordinating Committee on Cancer Research (UKCCCR) Ductal Carcinoma In Situ (DCIS) Working Party

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In one paragraph

Article in British journal of cancer, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Guideline
  2. Guideline
  3. Predictors for local invasive recurrence of ductal carcinoma in situ of the breast: a meta-analysis.European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2016
    Pooled it
  4. Guideline
  5. Trial
  6. Trial
  7. Prognostic and Predictive Value of HER2 Expression in Ductal Carcinoma In Situ: Results from the UK/ANZ DCIS Randomized Trial.Clinical cancer research : an official journal of the American Association for Cancer Research · 2021
    Trial
  8. Trial
  9. Article
  10. Observational
  11. Review
  12. Article
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  15. Article
  16. Morphological intratumor heterogeneity in ductal carcinoma in situ of the breast.Virchows Archiv : an international journal of pathology · 2021
    Article
  17. Prognostic Value of ER and PgR Expression and the Impact of Multi-clonal Expression for Recurrence in Ductal CarcinomaClinical cancer research : an official journal of the American Association for Cancer Research · 2021
    Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

S E PinderKing's College London, Division of Cancer Studies, Research Oncology, 3rd Floor, Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK. sarah.pinder@kcl.ac.uk
C Duggan
I O Ellis
J Cuzick
J F Forbes
H Bishop
I S Fentiman
W D George
UK Coordinating Committee on Cancer Research (UKCCCR) Ductal Carcinoma In Situ (DCIS) Working Party

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is no consensus agreement regarding optimal management of locally excised ductal carcinoma in situ (DCIS) or features of greatest assistance in predicting disease behaviour. Cases in the UKCCCR/ANZ DCIS trial have been histologically reviewed to determine the features of prognostic importance.

methodA total of 72% of 1694 cases entered into the UKCCCR/ANZ DCIS trial had full pathological review. A large number of histological features were assessed, blinded to outcome and compared regarding ability to predict ipsilateral recurrence, as either DCIS or progression to invasive carcinoma.

resultsPathological features associated with ipsilateral recurrence in univariate analysis included high cytonuclear grade, larger lesion size, growth pattern, presence of necrosis or chronic inflammation, incompleteness (or uncertainty of completeness) of excision and smaller margin width. Receipt of post-operative radiotherapy was also a strong prognostic factor.We report a novel sub-division of the large group of high-grade lesions, which enables identification of a very poor prognosis sub-group; namely, DCIS that is of high cytonuclear grade, predominantly (>50%) solid architecture, bearing extensive comedo-type necrosis (>50% of ducts). In addition, we found little difference in ipsilateral recurrence rates between low- and intermediate-grade groups. Hazard ratios for low, intermediate, high and the new, very high, grade were 0.42, 0.33, 0.62 and 1.00, respectively, for ipsilateral in situ or invasive recurrence.

conclusionWe present a novel pathological classification for DCIS with substantially better prognostic discrimination for ipsilateral recurrence than the classical categorisation based on cytonuclear grade alone.

Indexed as

Age FactorsBreast NeoplasmsCarcinoma, Ductal, BreastCarcinoma in SituFemaleHumansInflammationMultivariate AnalysisNeoplasm Recurrence, LocalRandomized Controlled Trials as Topic

Identifiers

PMID20517310
PMCPMC2905282

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.