ArticleBreast cancer research and treatment2021
Treating (low-risk) DCIS patients: What can we learn from real-world cancer registry evidence?
Article in Breast cancer research and treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The trial behind it
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Who cites it
15 citing papers in PubMed, 23 citations in OpenAlex.
- Diving Into the Gray Zone: A Patient Perspective on What Patient-Centered DCIS Care Really Means.Journal of patient experience · 2026Article
- Spatially Discontinuous Mutation Topographies in Ductal Carcinoma In Situ Reveal Noncompetitive Growth Dynamics.Cancer research · 2025Article
- Invasion prediction with artificial intelligence in ductal carcinoma in situ (DCIS) patients: a proof-of-concept study.BMC surgery · 2025Article
- The DCIS-IBC guide board on predicting postoperative upgrading in breast ductal carcinoma in situ: clinical insights from a multicenter study.Breast cancer research and treatment · 2025Article
- Article
- Multiplex characterization of circulating tumor cells from ductal carcinoma in situ patients suggests early tumor dissemination.Cancer letters · 2025Article
- Treatment and Outcome of Ductal Carcinoma in Situ for the German Federal States Berlin and Brandenburg in the Period 2007-2020.Geburtshilfe und Frauenheilkunde · 2025Article
- An early economic evaluation of active surveillance for low-risk ductal carcinomaFuture oncology (London, England) · 2024Article
- Growth Dynamics of Ductal Carcinoma in Situ Recapitulate Normal Breast Development.bioRxiv : the preprint server for biology · 2023Article
- Should low-risk DCIS lose the cancer label? An evidence review.Breast cancer research and treatment · 2023Review
- Women's views about current and future management of Ductal Carcinoma in Situ (DCIS): A mixed-methods study.PloS one · 2023Article
- Changes in breast cancer treatment during the COVID-19 pandemic: a Dutch population-based study.Breast cancer research and treatment · 2023Article
- Article
- Prediction of Upstaging in Ductal Carcinoma in Situ Based on Mammographic Radiomic Features.Radiology · 2022Article
- Low-risk DCIS. What is it? Observe or excise?Virchows Archiv : an international journal of pathology · 2022Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
purposeResults from active surveillance trials for ductal carcinoma in situ (DCIS) will not be available for > 10 years. A model based on real-world data (RWD) can demonstrate the comparative impact of non-intervention for women with low-risk features.
methodsMulti-state models were developed using Surveillance, Epidemiology, and End Results Program (SEER) data for three treatment strategies (no local treatment, breast conserving surgery [BCS], BCS + radiotherapy [RT]), and for women with DCIS low-risk features. Eligible cases included women aged ≥ 40 years, diagnosed with primary DCIS between 1992 and 2016. Five mutually exclusive health states were modelled: DCIS, ipsilateral invasive breast cancer (iIBC) ≤ 5 years and > 5 years post-DCIS diagnosis, contralateral IBC, death preceded by and death not preceded by IBC. Propensity score-weighted Cox models assessed effects of treatment, age, diagnosis year, grade, ER status, and race.
resultsData on n = 85,982 women were used. Increased risk of iIBC ≤ 5 years post-DCIS was demonstrated for ages 40-49 (Hazard ratio (HR) 1.86, 95% Confidence Interval (CI) 1.34-2.57 compared to age 50-69), grade 3 lesions (HR 1.42, 95%CI 1.05-1.91) compared to grade 2, lesion size ≥ 2 cm (HR 1.66, 95%CI 1.23-2.25), and Black race (HR 2.52, 95%CI 1.83-3.48 compared to White). According to the multi-state model, propensity score-matched women with low-risk features who had not died or experienced any subsequent breast event by 10 years, had a predicted probability of iIBC as first event of 3.02% for no local treatment, 1.66% for BCS, and 0.42% for BCS+RT.
conclusionRWD from the SEER registry showed that women with primary DCIS and low-risk features demonstrate minimal differences by treatment strategy in experiencing subsequent breast events. There may be opportunity to de-escalate treatment for certain women with low-risk features: Hispanic and non-Hispanic white women aged 50-69 at diagnosis, with ER+, grade 1 + 2, < 2 cm DCIS lesions.
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