Evidence map›Paper›PMID 33654083›Full record

ArticleNPJ breast cancer2021

Risk of hematologic malignancies after breast ductal carcinoma in situ treatment with ionizing radiation.

Kang Wang, Zhuyue Li, Xingxing Chen, Jianjun Zhang, Yongfu Xiong, Guochao Zhong, Yang Shi, Qing Li, Xiang Zhang, Hongyuan Li and 4 more

Open access · goldAbstract read
In one paragraph

Article in NPJ breast cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 58% of its field
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. 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

14 authors at 10 institutions in 3 countries.

Kang WangDepartment of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China.ORCID http://orcid.org/0000-0001-5401-1803
Zhuyue LiWest China Hospital/West China School of Nursing, Sichuan University, Chengdu, China.
Xingxing ChenDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Jianjun ZhangDepartment of Epidemiology, Fairbanks School of Public Health and Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, 1050 Wishard Boulevard RG5118, Indianapolis, IN, USA.
Yongfu XiongThe First Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Guochao ZhongDepartment of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Yang ShiDivision of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA.
Qing LiDepartment of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China.
Xiang ZhangDepartment of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China.
Hongyuan LiDepartment of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China.
Tingxiu XiangKey Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.ORCID http://orcid.org/0000-0003-4589-0599
Theodoros FoukakisDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden. theodoros.foukakis@ki.se.ORCID http://orcid.org/0000-0001-8952-9987
Tomas RadivoyevitchQuantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. radivot@ccf.org.
Guosheng RenDepartment of Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China. rengs726@126.com.ORCID http://orcid.org/0000-0002-6416-8967
The Affiliated Yongchuan Hospital of Chongqing Medical University · CNAffiliated Hospital of North Sichuan Medical College · CNAugusta University · USCleveland Clinic Lerner College of Medicine · USDalian Medical University · CNIndiana University Health · USKarolinska Institutet · SEKarolinska University Hospital · SEShanghai Medical College of Fudan University · CNSichuan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The increased incidence of secondary hematologic malignancies (SHM) is a well-known, potentially fatal, complication after cancer treatment. It is unknown if patients with ductal carcinoma in situ (DCIS) of the breast treated with external beam radiotherapy (RT) and who survive long-term have increased risks of secondary hematologic malignancies (SHM), especially for low/intermediate-risk subsets with limited benefits from RT. DCIS patients in Surveillance, Epidemiology, and End Results (SEER) registries (1975-2016) were identified. Relative risks (RR), hazard ratio (HR), and standardized incidence ratios (SIR) were calculated to assess the SHM risk and subsequent survival times. SHM development, defined as a nonsynchronous SHM occurring ≥1 year after DCIS diagnosis, was our primary endpoint. Of 184,363 eligible patients with DCIS, 77,927 (42.3%) in the RT group, and 106,436 (57.7%) in the non-RT group, 1289 developed SHMs a median of 6.4 years (interquartile range, 3.5 to 10.3 years) after their DCIS diagnosis. Compared with DCIS patients in the non-RT group, RT was associated with increased early risk of developing acute lymphoblastic leukemia (ALL; hazard ratio, 3.15; 95% CI, 1.21 to 8.17; P = 0.02), and a delayed risk of non-Hodgkin lymphoma (NHL; hazard ratio, 1.33; 95% CI, 1.09 to 1.62; P < 0.001). This increased risk of ALL and NHL after RT was also observed in subgroup analyses restricted to low/intermediate-risk DCIS. In summary, our data suggest that RT after breast conserving surgery for DCIS patients should be cautiously tailored, especially for low and intermediate-risk patients. Long-term SHM surveillance after DCIS diagnosis is warranted.

Identifiers

PMID33654083
PMCPMC7925676
OpenAlexW3135547902

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.