Trends in adjuvant therapy after breast-conserving surgery for ductal carcinoma in situ of breast: a retrospective cohort study using the ... View Full Text


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Article Info

DATE

2021-10-19

AUTHORS

Daisuke Yotsumoto, Yasuaki Sagara, Hiraku Kumamaru, Naoki Niikura, Hiroaki Miyata, Chizuko Kanbayashi, Hitoshi Tsuda, Yutaka Yamamoto, Kenjiro Aogi, Makoto Kubo, Kenji Tamura, Naoki Hayashi, Minoru Miyashita, Takayuki Kadoya, Shigehira Saji, Masakazu Toi, Shigeru Imoto, Hiromitsu Jinno

ABSTRACT

PurposeRadiotherapy (RT) and endocrine therapy (ET) are standard treatment options after breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). We investigated the national patterns of adjuvant therapy use after BCS for DCIS in Japan.MethodsWe obtained relevant data of patients diagnosed with DCIS undergoing surgery and treated with BCS between 2014 and 2016 from the Japanese Breast Cancer Registry database. The relationship between the clinicopathologic, institutional, and regional factors, and adjuvant treatment was examined using multivariable analyses.ResultsWe identified 9516 patients who underwent BCS for DCIS. Overall, 23% received no adjuvant treatment, 71% received RT, 32% received ET, and 26% received combination therapy. The percentages of patients who received ET and combination therapy in 2016 were significantly lower [odds ratio (OR): 0.71, 0.77, respectively] than in 2014. The proportion of RT was low among young or elderly patients (OR: 0.75, 0.44, respectively) and in non-certified facilities (OR: 0.56). The proportion of ET was high in non-certified facilities (OR: 1.58) and among patients with positive margins (OR: 1.62). Combination therapy was higher among patients with positive margins (OR: 1.53).ConclusionsOur study found a distinct adjuvant treatment pattern after BCS for DCIS depending on clinicopathologic factors, year, age, which indicate that physicians provide individualized treatment according to the background of the patients and the biology of DCIS. The facilities and regions remain significant factors of influencing adjuvant treatment pattern. More... »

PAGES

1-8

Journal

TITLE

Breast Cancer

ISSUE

1

VOLUME

29

Author Affiliations

  • Department of Breast Surgery, Sagara Hospital Miyazaki, Miyazaki Hakuaikai Medical Corporation, Miyazaki, Japan
  • Department of Breast Surgery, Sagara Hospital, Hakuaikai Medical Corporation, 3-28 Matsubara Kagoshima City, 892-0833, Kagoshima, Japan
  • Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
  • Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
  • Department of Breast Oncology, Niigata Cancer Center Hospital, Niigata, Japan
  • Department of Basic Pathology, National Defense Medical College, Saitama, Japan
  • Department of Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
  • Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
  • Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Department of Medical Oncology, Shimane University Hospital, Izumo, Shimane, Japan
  • Department of Breast Surgical Oncology, St. Luke’s International Hospital, Tokyo, Japan
  • Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
  • Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
  • Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
  • Breast Cancer Unit, Graduate School of Medicine, Kyoto University Hospital Breast Surgery, Kyoto University, Kyoto, Japan
  • Department of Breast Surgery, Kyorin University School of Medicine, Tokyo, Japan
  • Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s12282-021-01307-z

    DOI

    http://dx.doi.org/10.1007/s12282-021-01307-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1142004414

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34665435


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    22 schema:description PurposeRadiotherapy (RT) and endocrine therapy (ET) are standard treatment options after breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). We investigated the national patterns of adjuvant therapy use after BCS for DCIS in Japan.MethodsWe obtained relevant data of patients diagnosed with DCIS undergoing surgery and treated with BCS between 2014 and 2016 from the Japanese Breast Cancer Registry database. The relationship between the clinicopathologic, institutional, and regional factors, and adjuvant treatment was examined using multivariable analyses.ResultsWe identified 9516 patients who underwent BCS for DCIS. Overall, 23% received no adjuvant treatment, 71% received RT, 32% received ET, and 26% received combination therapy. The percentages of patients who received ET and combination therapy in 2016 were significantly lower [odds ratio (OR): 0.71, 0.77, respectively] than in 2014. The proportion of RT was low among young or elderly patients (OR: 0.75, 0.44, respectively) and in non-certified facilities (OR: 0.56). The proportion of ET was high in non-certified facilities (OR: 1.58) and among patients with positive margins (OR: 1.62). Combination therapy was higher among patients with positive margins (OR: 1.53).ConclusionsOur study found a distinct adjuvant treatment pattern after BCS for DCIS depending on clinicopathologic factors, year, age, which indicate that physicians provide individualized treatment according to the background of the patients and the biology of DCIS. The facilities and regions remain significant factors of influencing adjuvant treatment pattern.
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