Clinicopathological Characteristics and Factors Affecting Recurrence of Ductal Carcinoma In Situ in Korean Women

Purpose: As breast cancer screening becomes more popular in Korea, incidence of ductal carcinoma in situ (DCIS) of breast has increased to more than 10% of all breast cancer diagnosed. We aimed to show the clinicopathological characteristics and factors affecting recurrence of DCIS in Korean women. Methods: We retrospectively reviewed 152 DCIS patients who underwent breast conserving surgery in Seoul National University Hospital between January 1995 and December 2005. Results: Mean age at diagnosis was 46.7 years (24 to 66 years). Mean follow up duration of the patients was 73.82 months (0.80 to 168.43 months). Recurrence of disease occurred in 19 (12.5%) patients: 2 in contralateral breast, 15 in ipsilateral breast, and 2 in axilla. One patient showed ipsilateral breast recur after excision of axillary metastasis. Eight (42.11%) of all recurrence was infiltrating ductal carcinoma and one of them showed bone metastasis during follow up. In an multivariate analysis of factors affecting recurrence, younger age at diagnosis and omission of radiotherapy had significant association with recurrence (p=0.005 and p=0.002, respectively). However, tumor size (p=0.862), microinvasion (p=0.988), histologic grade (p=0.157), estrogen receptor status (p=0.401) and resection margin status (p=0.112) were not significantly correlated with recurrence. There was no breast cancer associated mortality. Conclusion: In this study, we found that the younger age at diagnosis and omission of adjuvant radiotherapy are independent predictors of recurrence in Korean DCIS patients.Pinder SE, 2010, BRIT J CANCER, V103, P94, DOI 10.1038/sj.bjc.6605718Bundred NJ, 2010, CLIN CANCER RES, V16, P1605, DOI 10.1158/1078-0432.CCR-09-1623Virnig BA, 2010, J NATL CANCER I, V102, P170, DOI 10.1093/jnci/djp482Allegra CJ, 2010, J NATL CANCER I, V102, P161, DOI 10.1093/jnci/djp485Thomas J, 2010, BRIT J CANCER, V102, P285, DOI 10.1038/sj.bjc.6605513Collins LC, 2009, AM J SURG PATHOL, V33, P1802Hughes LL, 2009, J CLIN ONCOL, V27, P5319, DOI 10.1200/JCO.2009.21.8560Shah DN, 2009, BREAST J, V15, P649, DOI 10.1111/j.1524-4741.2009.00838.xGoodwin A, 2009, BREAST, V18, P143, DOI 10.1016/j.breast.2009.04.003Chung YS, 2009, J BREAST CANCER, V12, P106, DOI 10.4048/jbc.2009.12.2.106Dunne C, 2009, J CLIN ONCOL, V27, P1615, DOI 10.1200/JCO.2008.17.5182Kuerer HM, 2009, J CLIN ONCOL, V27, P279, DOI 10.1200/JCO.2008.18.3103Luini A, 2009, BREAST CANCER RES TR, V113, P397, DOI 10.1007/s10549-008-9929-0von Smitten K, 2008, J SURG ONCOL, V98, P585, DOI 10.1002/jso.21038Ko SS, 2008, J SURG ONCOL, V98, P318, DOI 10.1002/jso.21110Sakorafas GH, 2008, CANCER TREAT REV, V34, P483, DOI 10.1016/j.ctrv.2008.03.001Morrow M, 2008, ANN SURG ONCOL, V15, P2641, DOI 10.1245/s10434-008-0083-zIntra M, 2008, ANN SURG, V247, P315, DOI 10.1097/SLA.0b013e31815b446bAllred DC, 2008, CLIN CANCER RES, V14, P370, DOI 10.1158/1078-0432.CCR-07-1127RHEE J, 2008, BMC CANCER, V8, pNIL19, DOI DOI 10.1186/1471-2407-8-307Moore KH, 2007, ANN SURG ONCOL, V14, P2911, DOI 10.1245/s10434-007-9414-8Sontag L, 2005, J THEOR BIOL, V232, P179, DOI 10.1016/j.jtbi.2004.08.002Boland GP, 2003, BRIT J SURG, V90, P426, DOI 10.1002/bjs.4051Vicini FA, 2002, J CLIN ONCOL, V20, P2736, DOI 10.1200/JCO.2002.07.137Neuschatz AC, 2002, CANCER, V94, P1917, DOI 10.1002/cncr.10460Bartelink H, 2001, NEW ENGL J MED, V345, P1378Bijker N, 2001, J CLIN ONCOL, V19, P2263LEE HD, 2001, J KOREAN SURG SOC, V60, P495FRYKBERG ER, 1997, BREAST J, V3, P227

The Impact of Primary Tumor Resection on the Survival of Patients with Stage IV Breast Cancer

Purpose The main treatment for stage IV breast cancer is currently systemic therapy. Surgical resection of the primary tumor is usually done for treating the tumor-related complications Recent studies have suggested that surgery may improve the long-term survival of stage IV breast cancer patients We evaluated the impact of the primary surgical resection site on the survival of stage IV breast cancer patients. Methods We reviewed the records of the stage IV breast cancer patients who were treated at Seoul University Hospital between April 1992 and December 2007 The tumor and clinical characteristics, the type of treatments and the overall survival were compared between the surgically versus nonsurgically treated patients. Results. Of the 198 identified patients, 110 (55 8%) received surgical excision of their primary tumor and 88 (44 2%) did not The mean survival was 67 months vs. 42 months for the surgically treated patients vs the patients without surgery, respectively (p=0 0287) On a multivariate analysis with using the Cox model and after adjusting for the estrogen receptor status, visceral metastases, the number of metastatic sites and trastuzumab treatment, surgery was an independent factor for improved survival (hazard ratio, 0.55; 95% confidence interval, 0.31-0.97; p=0.041). Conclusion Surgical resection of the primary tumor in stage IV breast cancer patients was independently associated with improved survival. Randomized prospective trials are needed to firmly recommend surgical resection of the primary tumor in stage IV breast cancer patients본 연구는 폐암, 유방암/난소암 유전체 연구센터의 연구비를 지원받아 수행 되었음(01-PJ3-PG6-01GN07-0004).Bafford AC, 2009, BREAST CANCER RES TR, V115, P7, DOI 10.1007/s10549-008-0101-7Blanchard DK, 2008, ANN SURG, V247, P732, DOI 10.1097/SLA.0b013e3181656d32*KOR BREAST CANC S, 2008, BREAST CANC FACTS FI, V1, P5Fields RC, 2007, ANN SURG ONCOL, V14, P3345, DOI 10.1245/s10434-007-9527-0Gnerlich J, 2007, ANN SURG ONCOL, V14, P2187, DOI 10.1245/s10434-007-9438-0Rapiti E, 2006, J CLIN ONCOL, V24, P2743, DOI 10.1200/JCO.2005.04.2226Morrow M, 2006, J CLIN ONCOL, V24, P2694, DOI 10.1200/JCO.2006.05.9824Babiera GV, 2006, ANN SURG ONCOL, V13, P776, DOI 10.1245/ASO.2006.03.033Hotta T, 2006, ANTICANCER RES, V26, P1377Abe O, 2005, LANCET, V366, P2087Andre F, 2004, J CLIN ONCOL, V22, P3302, DOI 10.1200/JCO.2004.08.095Giordano SH, 2004, CANCER, V100, P44, DOI 10.1002/cncr.11859Khan SA, 2002, SURGERY, V132, P620, DOI 10.1067/msy.2002.127544Flanigan RC, 2001, NEW ENGL J MED, V345, P1655Demicheli R, 2001, BRIT J CANCER, V85, P490Dauplat J, 2000, SEMIN SURG ONCOL, V19, P42Overgaard M, 1999, SEMIN RADIAT ONCOL, V9, P292DOGHETTO GB, 1999, AM SURGEON, V65, P352BLAND KI, 1998, BREAST COMPREHENSIVE, V2Ragaz J, 1997, NEW ENGL J MED, V337, P956OREILLY MS, 1994, CELL, V79, P315FISHER B, 1989, CANCER RES, V49, P1996*NAT CANC I, BREAST CANC TREATM P