ArticleNPJ breast cancer2024
Lumpectomy without radiation for ductal carcinoma in situ of the breast: 20-year results from the ECOG-ACRIN E5194 study.
Article in NPJ breast cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed, 12 citations in OpenAlex.
- Recurrence Patterns and Overtreatment in Pure DCIS: A Retrospective Clinical and Radiological Follow-Up Study.Journal of personalized medicine · 2026Article
- Impact of Tamoxifen Only After Lumpectomy for "Good-Risk" Duct Carcinoma In Situ: Combined Analysis of the NRG Oncology/RTOG 9804 and ECOG-ACRIN E5194 Trials.International journal of radiation oncology, biology, physics · 2026Article
- From overtreatment to precision: a new clinical standard for DCIS management.Cancer biology & medicine · 2026Article
- Spatiotemporal microenvironment landscape and malignant epithelial pattern transition in breast ductal carcinoma progression.Journal of translational medicine · 2025Article
- Current pattern of care in radiation therapy for DCIS in Australia and New Zealand - where are we heading?Breast (Edinburgh, Scotland) · 2025Article
- Article
- Update on the management of ductal carcinoma in situ of the breast: current approach and future perspectives.Japanese journal of clinical oncology · 2025Review
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Authors and funding
10 authors at 9 institutions in 1 country.
Funding
Abstract
We report the 20-year rate of ipsilateral breast event (IBE) for patients with ductal carcinoma in situ (DCIS) treated with lumpectomy without radiation on a non-randomized prospective clinical trial. Patients were enrolled in cohort 1: low- or intermediate-grade DCIS, size ≤ 2.5 cm (n = 561); or cohort 2: high-grade DCIS, size ≤ 1 cm (n = 104). The Kaplan-Meier method was used to estimate time-to-event distributions. Cox proportional hazard methods were used to estimate hazard ratios (HRs) and tests for significance for event times. 561 patients were enrolled in cohort 1 and 104 in cohort 2. After central pathology review, 26% in cohort 1 were recategorized as high-grade and 26% in cohort 2 as low- or intermediate-grade. Mean DCIS size was similar at 7.5 mm in cohort 1 and 7.8 mm in cohort 2. Surgical margin was ≥3 mm in 96% of patients, and about 30% received tamoxifen. Median follow-up was 19.2 years. There were 104 IBEs, of which 54 (52%) were invasive. The IBE and invasive IBE rates increased in both cohorts up to 15 years, then plateaued. The 20-year IBE rates were 17.8% for cohort 1 and 28.7% for cohort 2 (p = 0.005), respectively. Invasive IBE occurred in 9.8% and 15.1% (p = 0.09), respectively. On multivariable analysis, IBE risk increased with size and was higher in cohort 2, but grade and margin width were not significantly associated with IBE. For patients with DCIS treated with excision without radiation, the rate of IBE increased with size and assigned cohort mostly in the first 15 years.
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Registered trials
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