Evidence map›Paper›PMID 39213131›Full record

Observational studyThe British journal of surgery2024

Disease-specific survival outcomes for patients after locoregional treatment for ductal carcinoma in situ: observational cohort study.

Sabrina M Wang, Yan Li, Amanda Nash, Yi Ren, Samantha M Thomas, Amanda B Francescatti, Anne Barber, Thomas Lynch, Elizabeth S Frank, Lars J Grimm and 5 more

Erratum issuedAbstract readObservational StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The British journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Sabrina M WangDepartment of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Yan LiDuke Cancer Institute Biostatistics Shared Resource, Duke University Medical Center, Durham, North Carolina, USA.
Amanda NashDepartment of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Yi RenDuke Cancer Institute Biostatistics Shared Resource, Duke University Medical Center, Durham, North Carolina, USA.
Samantha M ThomasDuke Cancer Institute Biostatistics Shared Resource, Duke University Medical Center, Durham, North Carolina, USA.
Amanda B FrancescattiCancer Programs, American College of Surgeons, Chicago, Illinois, USA.
Anne BarberCancer Programs, American College of Surgeons, Chicago, Illinois, USA.
Thomas LynchDepartment of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Elizabeth S FrankDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Lars J GrimmDepartment of Radiology, Duke University Medical Center, Durham, North Carolina, USA.ORCID 0000-0002-3865-3352
Alastair M ThompsonDepartment of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Ann H PartridgeDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Terry HyslopDivision of Biostatistics & Bioinformatics, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
E Shelley HwangDepartment of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Marc D RyserDepartment of Population Health Sciences, Duke University Medical Center, Durham, North Carolina, USA.

Funding

(PQC3) Genomic Diversity and Microenvironment as Drivers of Metastasis in DCISR01CA185138 · NCI · DUKE UNIVERSITY · PI HWANG, E.SHELLEY, MALEY, CARLO · 2014 to 2017
$2.0M
The Mathematics of Breast Cancer Overtreatment: Improving Treatment Choice through Effective Communication of Personalized Cancer RiskR00CA207872 · NCI · DUKE UNIVERSITY · PI RYSER, MARC · 2018 to 2020
$746k
NCI NIH HHS R00 CA207872NCI NIH HHS R01 CA185138Patient-Centered Outcomes Research Institute
6 · The paper itself

Abstract

backgroundBreast-conserving surgery alone, breast-conserving surgery with adjuvant radiation treatment, and mastectomy are guideline-concordant treatments for ductal carcinoma in situ. The aim of this study was to compare survival outcomes between these treatment options.

methodsA stratified random sample of patients diagnosed with pure ductal carcinoma in situ between 2008 and 2014 was selected from 1330 sites in the USA. Data on diagnosis, treatment, and follow-up were abstracted by local cancer registrars. Population-averaged marginal estimates of disease-specific survival and overall survival for breast-conserving surgery alone, breast-conserving surgery with radiation treatment, and mastectomy were obtained by combining sampling and overlap weights.

resultsA total of 18 442 women were included, with a median follow-up of 67.8 (interquartile range 46.1-93.5) months. A total of 35 women died from breast cancer, at a median age of 62 (interquartile range 50-74) years. Population-averaged 8-year rates of disease-specific survival were 99.6% or higher for all treatment groups, with no significant differences between groups (breast-conserving surgery alone versus breast-conserving surgery with radiation treatment, HR 1.19 (95% c.i. 0.29 to 4.85); and mastectomy versus breast-conserving surgery with radiation treatment, HR 1.74 (95% c.i. 0.53 to 5.72). There was no difference in overall survival between the patients who underwent a mastectomy and the patients who underwent breast-conserving surgery with radiation treatment (HR 1.09 (95% c.i. 0.83 to 1.43)). Patients who underwent breast-conserving surgery alone had lower overall survival compared with the patients who underwent breast-conserving surgery with radiation treatment (HR 1.29 (95% c.i. 1.00 to 1.67)). This survival difference vanished for all but one subgroup, namely patients less than 65 years (HR 1.86 (95% c.i. 1.15 to 3.00)).

conclusionThere was no statistically significant difference in disease-specific survival between women operated with breast-conserving surgery alone, breast-conserving surgery with radiation treatment, or mastectomy for ductal carcinoma in situ. Given the low absolute risk of disease-specific mortality, these results provide confidence in offering individualized locoregional treatment without fear of compromising survival.

Indexed as

Breast NeoplasmsCarcinoma, Intraductal, NoninfiltratingMastectomyMastectomy, SegmentalAgedFemaleHumansMiddle AgedRadiotherapy, AdjuvantTreatment OutcomeUnited States

Identifiers

PMID39213131
PMCPMC12098000

What OpenQuestion holds

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Registered trials

None linked

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.