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Histopathological r...
Histopathological risk factors for ipsilateral breast events after breast conserving treatment for ductal carcinoma in situ of the breast--results from the Swedish randomised trial.
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- Ringberg, Anita (author)
- Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups,Department of Plastic Surgery, Malmö University Hospital, Malmö, Sweden
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- Nordgren, H (author)
- Uppsala universitet,Institutionen för patologi,Department of Pathology, University Hospital, Uppsala, Sweden
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- Thorstensson, S (author)
- Department of Pathology, Central Hospital, Kalmar, Sweden
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- Idvall, Ingrid (author)
- Lund University,Lunds universitet,Tumörmikromiljö,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Tumor microenvironment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Department of Pathology, Malmö University Hospital, Malmö, Sweden
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- Garmo, H (author)
- Uppsala universitet,Regional Oncologic Center, University Hospital, Uppsala, Sweden
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- Granstrand, B (author)
- Department of Surgery, Norrland University Hospital, Umeå, Sweden
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- Arnesson, Lars-Gunnar (author)
- Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Kirurgi,Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala
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- Sandelin, K (author)
- Karolinska Institutet,Department of Surgery, Karolinska Hospital, Stockholm, Sweden
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- Wallgren, Arne, 1940 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences,Department of Oncology, Sahlgenska University Hospital, Gothenburg, Sweden
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- Anderson, Harald (author)
- Lund University,Lunds universitet,Medicinsk onkologi,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medical oncology,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Regional Oncologic Center, University Hospital, Lund, Sweden
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- Emdin, Stefan (author)
- Umeå universitet,Kirurgi,Department of Surgery, Norrland University Hospital, Umeå, Sweden
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- Holmberg, Lars (author)
- Uppsala universitet,Endokrinkirurgi,Regional Oncologic Center, University Hospital, Uppsala, Sweden
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(creator_code:org_t)
- Elsevier BV, 2007
- 2007
- English.
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In: European journal of cancer (Oxford, England : 1990). - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 43:2, s. 291-8
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Abstract
Subject headings
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- AIM: The primary aims were to study risk factors for an ipsilateral breast event (IBE) after sector resection for ductal carcinoma in situ of the breast (DCIS) in a trial comparing adjuvant radiotherapy to no therapy and to assess predictive factors for response to radiotherapy. Secondary aims were to analyse reproducibility of the histopathological evaluation and to estimate correctness of diagnosis in the trial. SETTING: A randomised trial in Sweden (the SweDCIS trial), including 1046 women with a median of 5.2 years of follow-up in a population, offered routine mammographic screening. METHODS: A case-cohort design with a total of 161 cases of IBE (42 of those being members of the subcohort) and 284 sampled for the sub-cohort. Ninety five percent of the participants' slides could be retrieved and were re-evaluated by three experienced pathologists. RESULTS: Low nuclear grade (NG 1-2) and absence of necrosis halves the risk of IBE in both irradiated and non-irradiated patients. Lesion size, margins of excision and age at diagnosis did not modify these associations. The presence of necrosis modified the effect of radiotherapy: relative risk was 0.40 with necrosis present and 0.07 with necrosis absent (p-value for interaction 0.068). In all subsets of prognostic factors, radiotherapy conferred a substantial benefit. The risk factors for in situ and invasive IBE were similar. The agreement between pathologists was moderate (kappa=0.486). Correctness of diagnosis in the subcohort of SweDCIS was 84.8%. CONCLUSION: Although nuclear grade and necrosis carry prognostic information, we could not define a group with very low risk after sector resection alone. Radiotherapy has a protective effect in all substrata of risk factors studied. The interaction between the presence of necrosis and radiotherapy is a clinically and biologically relevant research area.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Breast Neoplasms
- pathology
- radiotherapy
- surgery
- Carcinoma
- Ductal
- Breast
- pathology
- radiotherapy
- surgery
- Case-Control Studies
- Cohort Studies
- Female
- Humans
- Mastectomy
- Segmental
- Radiotherapy
- Adjuvant
- Risk Factors
- case-cohort
- risk factors
- ductal carcinoma in situ
- breast
- nuclear grade
- randomised clinical trial
- reproducibility
- breast conserving therapy
- necrosis
- Breast Neoplasms/*pathology/radiotherapy/surgery
- MEDICINE
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
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Ringberg, Anita
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Nordgren, H
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Thorstensson, S
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Idvall, Ingrid
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Garmo, H
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Granstrand, B
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Arnesson, Lars-G ...
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Sandelin, K
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Wallgren, Arne, ...
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Anderson, Harald
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Emdin, Stefan
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Holmberg, Lars
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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European journal ...
- By the university
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University of Gothenburg
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Lund University
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Umeå University
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Uppsala University
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Karolinska Institutet
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Linköping University