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Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast

Malmström, Per (creator_code:cre_t)
Lund University,Lunds universitet,Medicinska fakulteten,Faculty of Medicine
McGale, P (author)
Wang, Y (author)
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Clarke, M (author)
Davies, C (author)
Peto, R (author)
Bijker, N (author)
Solin, L (author)
Darby, S (author)
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 (creator_code:org_t)
 
2010-10-18
2010
English.
In: Journal of the National Cancer Institute. Monographs. - : Oxford University Press (OUP). - 1052-6773 .- 1745-6614. ; 2010:41, s. 162-177
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Individual patient data were available for all four of the randomized trials that began before 1995, and that compared adjuvant radiotherapy vs no radiotherapy following breast-conserving surgery for ductal carcinoma in situ (DCIS). A total of 3729 women were eligible for analysis. Radiotherapy reduced the absolute 10-year risk of any ipsilateral breast event (ie, either recurrent DCIS or invasive cancer) by 15.2% (SE 1.6%, 12.9% vs 28.1% 2 P <.00001), and it was effective regardless of the age at diagnosis, extent of breast-conserving surgery, use of tamoxifen, method of DCIS detection, margin status, focality, grade, comedonecrosis, architecture, or tumor size. The proportional reduction in ipsilateral breast events was greater in older than in younger women (2P < .0004 for difference between proportional reductions; 10-year absolute risks: 18.5% vs 29.1% at ages <50 years, 10.8% vs 27.8% at ages ≥ 50 years) but did not differ significantly according to any other available factor. Even for women with negative margins and small low-grade tumors, the absolute reduction in the 10-year risk of ipsilateral breast events was 18.0% (SE 5.5, 12.1% vs 30.1%, 2P = .002). After 10 years of follow-up, there was, however, no significant effect on breast cancer mortality, mortality from causes other than breast cancer, or all-cause mortality.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Keyword

Adult
Aged
Antineoplastic Agents, Hormonal/therapeutic use
Breast Neoplasms/drug therapy
Carcinoma, Ductal, Breast/epidemiology
Carcinoma, Intraductal, Noninfiltrating/drug therapy
Chemotherapy, Adjuvant
Combined Modality Therapy
Female
Humans
Mastectomy, Segmental
Meta-Analysis as Topic
Middle Aged
Multicenter Studies as Topic/statistics & numerical data
Neoplasm Recurrence, Local/epidemiology
Neoplasms, Second Primary/epidemiology
Radiotherapy, Adjuvant/statistics & numerical data
Randomized Controlled Trials as Topic/statistics & numerical data
Tamoxifen/therapeutic use

Publication and Content Type

art (subject category)
ref (subject category)

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