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Ductal Carcinoma in Situ: A French National Survey. Analysis of 2125 Patients.

Abstract

BACKGROUND

Ductal carcinoma in situ (DCIS) represents 15% of all breast cancers in France. The first national survey was conducted in 2003. The present multi-center real-life practice survey aimed at assessing possible changes in demographic, clinical, pathologic, and treatment features.

MATERIAL AND METHODS

From March 2014 to September 2015, patients diagnosed with DCIS from 71 centers with complete information about age, diagnostic features, and treatment modalities were prospectively included.

RESULTS

A total of 2125 patients with a median age of 58.6 years from 71 centers were studied. DCIS was diagnosed by mammography in 87.5% of cases. Preoperative biopsy was performed in 96% of cases. The median tumor size was 15 mm. Nuclear grade was low, intermediate, and high in 12%, 36%, and 47% of cases, respectively. Margins were considered to be negative in 83% of cases. Overall mastectomy and lumpectomy rates were 25% and 75%, respectively. The immediate breast reconstruction rate was 50%. Sentinel node biopsy and axillary dissection rates were 41% and 2.6%, respectively. After lumpectomy, 97% of patients underwent radiotherapy, and 32% received a boost dose. Only 1% of patients received endocrine therapy. Compared with our previous survey, the median tumor size remained the same, and the proportion of high-grade lesions increased by 9%. The mastectomy rate decreased by 4%.

CONCLUSIONS

The clinical practice identified in this survey complies with French DCIS guidelines. About 10% of patients with low-grade DCIS may be eligible to participate in treatment de-escalation trials.

Authors+Show Affiliations

Department of Radiation Oncology, Institut du Cancer Courlancy, Reims, France. Electronic address: bcutuli@iccreims.fr.Department of Radiation Oncology, Institut du Cancer Montpellier, Montpellier, France.Department of Radiation Oncology, Oncopole, IUCT, Toulouse, France.Department of Surgical Oncology, Centre Oscar Lambret, Lille, France.Department of Surgical Oncology, Institut Bergonié, Bordeaux, France.Department of Radiation Oncology, Institut Sainte Catherine, Avignon, France.Department of Radiation Oncology, Institut Daniel Hollard, Grenoble, France.Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France.Department of Surgical Oncology, Institut Gustave Roussy, Villejuif, France.Department of Medical Oncology, Hôpital Saint Louis, Paris, France.Sylia Stat, Bourg-la-Reine, France.Department of Radiation Oncology, Institut Curie, Paris, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31780381

Citation

Cutuli, Bruno, et al. "Ductal Carcinoma in Situ: a French National Survey. Analysis of 2125 Patients." Clinical Breast Cancer, 2019.
Cutuli B, Lemanski C, De Lafontan B, et al. Ductal Carcinoma in Situ: A French National Survey. Analysis of 2125 Patients. Clin Breast Cancer. 2019.
Cutuli, B., Lemanski, C., De Lafontan, B., Chauvet, M. P., De Lara, C. T., Mege, A., ... Kirova, Y. (2019). Ductal Carcinoma in Situ: A French National Survey. Analysis of 2125 Patients. Clinical Breast Cancer, doi:10.1016/j.clbc.2019.08.002.
Cutuli B, et al. Ductal Carcinoma in Situ: a French National Survey. Analysis of 2125 Patients. Clin Breast Cancer. 2019 Aug 22; PubMed PMID: 31780381.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ductal Carcinoma in Situ: A French National Survey. Analysis of 2125 Patients. AU - Cutuli,Bruno, AU - Lemanski,Claire, AU - De Lafontan,Brigitte, AU - Chauvet,Marie-Pierre, AU - De Lara,Christine Tunon, AU - Mege,Alice, AU - Fric,Daniele, AU - Richard-Molard,Marion, AU - Mazouni,Chafica, AU - Cuvier,Caroline, AU - Carre,Agnes, AU - Kirova,Youla, Y1 - 2019/08/22/ PY - 2019/05/12/received PY - 2019/08/04/revised PY - 2019/08/06/accepted PY - 2019/11/30/entrez PY - 2019/11/30/pubmed PY - 2019/11/30/medline KW - DCIS KW - Mastectomy KW - Radiotherapy KW - Sentinel node biopsy KW - Surgery KW - Treatment JF - Clinical breast cancer JO - Clin. Breast Cancer N2 - BACKGROUND: Ductal carcinoma in situ (DCIS) represents 15% of all breast cancers in France. The first national survey was conducted in 2003. The present multi-center real-life practice survey aimed at assessing possible changes in demographic, clinical, pathologic, and treatment features. MATERIAL AND METHODS: From March 2014 to September 2015, patients diagnosed with DCIS from 71 centers with complete information about age, diagnostic features, and treatment modalities were prospectively included. RESULTS: A total of 2125 patients with a median age of 58.6 years from 71 centers were studied. DCIS was diagnosed by mammography in 87.5% of cases. Preoperative biopsy was performed in 96% of cases. The median tumor size was 15 mm. Nuclear grade was low, intermediate, and high in 12%, 36%, and 47% of cases, respectively. Margins were considered to be negative in 83% of cases. Overall mastectomy and lumpectomy rates were 25% and 75%, respectively. The immediate breast reconstruction rate was 50%. Sentinel node biopsy and axillary dissection rates were 41% and 2.6%, respectively. After lumpectomy, 97% of patients underwent radiotherapy, and 32% received a boost dose. Only 1% of patients received endocrine therapy. Compared with our previous survey, the median tumor size remained the same, and the proportion of high-grade lesions increased by 9%. The mastectomy rate decreased by 4%. CONCLUSIONS: The clinical practice identified in this survey complies with French DCIS guidelines. About 10% of patients with low-grade DCIS may be eligible to participate in treatment de-escalation trials. SN - 1938-0666 UR - https://www.unboundmedicine.com/medline/citation/31780381/Ductal_Carcinoma_in_Situ:_A_French_National_Survey._Analysis_of_2125_Patients L2 - https://linkinghub.elsevier.com/retrieve/pii/S1526-8209(19)30641-X DB - PRIME DP - Unbound Medicine ER -