Evidence map›Paper›PMID 26424776›Full record

ArticleJournal of the National Cancer Institute2015

Trends in Treatment Patterns and Outcomes for Ductal Carcinoma In Situ.

Mathias Worni, Igor Akushevich, Rachel Greenup, Deba Sarma, Marc D Ryser, Evan R Myers, E Shelley Hwang

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the National Cancer Institute, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
96citing papers in PubMed, 5 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

96 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  7. Phase II Single-Arm Study of Preoperative Letrozole for Estrogen Receptor-Positive Postmenopausal Ductal Carcinoma In Situ: CALGB 40903 (Alliance).Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020
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36 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Mathias WorniDivision of Advanced Oncologic and GI Surgery, Department of Surgery, (MW, RG, DS, ESH), Center for Population Health and Aging (IA), Department of Obstetrics and Gynecology (ERM), and Department of Mathematics (MDR), Duke University Medical Center, Durham NC; Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland (MW).
Igor AkushevichDivision of Advanced Oncologic and GI Surgery, Department of Surgery, (MW, RG, DS, ESH), Center for Population Health and Aging (IA), Department of Obstetrics and Gynecology (ERM), and Department of Mathematics (MDR), Duke University Medical Center, Durham NC; Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland (MW).
Rachel GreenupDivision of Advanced Oncologic and GI Surgery, Department of Surgery, (MW, RG, DS, ESH), Center for Population Health and Aging (IA), Department of Obstetrics and Gynecology (ERM), and Department of Mathematics (MDR), Duke University Medical Center, Durham NC; Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland (MW).
Deba SarmaDivision of Advanced Oncologic and GI Surgery, Department of Surgery, (MW, RG, DS, ESH), Center for Population Health and Aging (IA), Department of Obstetrics and Gynecology (ERM), and Department of Mathematics (MDR), Duke University Medical Center, Durham NC; Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland (MW).
Marc D RyserDivision of Advanced Oncologic and GI Surgery, Department of Surgery, (MW, RG, DS, ESH), Center for Population Health and Aging (IA), Department of Obstetrics and Gynecology (ERM), and Department of Mathematics (MDR), Duke University Medical Center, Durham NC; Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland (MW).
Evan R MyersDivision of Advanced Oncologic and GI Surgery, Department of Surgery, (MW, RG, DS, ESH), Center for Population Health and Aging (IA), Department of Obstetrics and Gynecology (ERM), and Department of Mathematics (MDR), Duke University Medical Center, Durham NC; Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland (MW).
E Shelley HwangDivision of Advanced Oncologic and GI Surgery, Department of Surgery, (MW, RG, DS, ESH), Center for Population Health and Aging (IA), Department of Obstetrics and Gynecology (ERM), and Department of Mathematics (MDR), Duke University Medical Center, Durham NC; Department of Visceral Surgery and Medicine, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland (MW). shelley.hwang@duke.edu.

Funding

Causal Effects of Time-Dependent Treatment: Optimizing Care of Cancer PatientsR21AG045245 · NIA · DUKE UNIVERSITY · PI AKUSHEVICH, IGOR · 2013 to 2013
$150k
NIA NIH HHS R21 AG045245
6 · The paper itself

Abstract

backgroundImpact of contemporary treatment of pre-invasive breast cancer (ductal carcinoma in situ [DCIS]) on long-term outcomes remains poorly defined. We aimed to evaluate national treatment trends for DCIS and to determine their impact on disease-specific (DSS) and overall survival (OS).

methodsThe Surveillance, Epidemiology, and End Results (SEER) registry was queried for patients diagnosed with DCIS from 1991 to 2010. Treatment pattern trends were analyzed using Cochran-Armitage trend test. Survival analyses were performed using inverse probability weights (IPW)-adjusted competing risk analyses for DSS and Cox proportional hazard regression for OS. All tests performed were two-sided.

resultsOne hundred twenty-one thousand and eighty DCIS patients were identified. The greatest proportion of patients was treated with lumpectomy and radiation therapy (43.0%), followed by lumpectomy alone (26.5%) and unilateral (23.8%) or bilateral mastectomy (4.5%) with significant shifts over time. The rate of sentinel lymph node biopsy increased from 9.7% to 67.1% for mastectomy and from 1.4% to 17.8% for lumpectomy. Compared with mastectomy, OS was higher for lumpectomy with radiation (hazard ratio [HR] = 0.79, 95% confidence interval [CI] = 0.76 to 0.83, P < .001) and lower for lumpectomy alone (HR = 1.17, 95% CI = 1.13 to 1.23, P < .001). IPW-adjusted ten-year DSS was highest in lumpectomy with XRT (98.9%), followed by mastectomy (98.5%), and lumpectomy alone (98.4%).

conclusionsWe identified substantial shifts in treatment patterns for DCIS from 1991 to 2010. When outcomes between locoregional treatment options were compared, we observed greater differences in OS than DSS, likely reflecting both a prevailing patient selection bias as well as clinically negligible differences in breast cancer outcomes between groups.

Indexed as

Sentinel Lymph Node BiopsyAdultAgedBiomarkers, TumorBreast NeoplasmsCarcinoma, Intraductal, NoninfiltratingConfounding Factors, EpidemiologicDisease-Free SurvivalFemaleHumansMastectomyMastectomy, Modified RadicalMastectomy, SegmentalMiddle AgedNeoplasm GradingNeoplasm StagingBiomarkers, TumorReceptors, EstrogenReceptors, Progesterone

Identifiers

PMID26424776
PMCPMC4707192

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.