Association between patient and tumor characteristics with clinical outcomes in women with ductal carcinoma in situ

J Natl Cancer Inst Monogr. 2010;2010(41):121-9. doi: 10.1093/jncimonographs/lgq034.

Abstract

We synthesized the evidence of the association between patient and tumor characteristics with clinical outcomes in women with ductal carcinoma in situ of the breast. We identified five randomized controlled clinical trials and 64 observational studies that were published in English from January 1970 to January 2009. Younger women with clinically presented ductal carcinoma in situ had higher risk of ipsilateral recurrent cancer. African Americans had higher mortality and greater rates of advanced recurrent cancer. Women with larger tumor size, comedo necrosis, worse pathological grading, positive surgical margins, and at a higher risk category, using a composite prognostic index, had worse outcomes. Inconsistent evidence suggested that positive HER2 receptor and negative estrogen receptor status were associated with worse outcomes. Synthesis of evidence was hampered by low statistical power to detect significant differences in predictor categories and inconsistent adjustment practices across the studies. Future research should address composite prediction indices among race groups for all outcomes.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Body Mass Index
  • Breast Neoplasms / chemistry
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy
  • Carcinoma, Intraductal, Noninfiltrating / chemistry
  • Carcinoma, Intraductal, Noninfiltrating / epidemiology*
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Carcinoma, Intraductal, Noninfiltrating / therapy
  • Continental Population Groups / statistics & numerical data
  • Female
  • Gonadal Steroid Hormones / adverse effects
  • Humans
  • Mammography
  • Menopause
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasms, Hormone-Dependent / chemistry
  • Neoplasms, Hormone-Dependent / epidemiology
  • Neoplasms, Hormone-Dependent / pathology
  • Neoplasms, Hormone-Dependent / therapy
  • Prognosis
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Receptor, ErbB-2 / analysis
  • Receptors, Estrogen / analysis
  • Receptors, Progesterone / analysis
  • Risk
  • Socioeconomic Factors
  • Treatment Outcome
  • Tumor Burden

Substances

  • Gonadal Steroid Hormones
  • Receptors, Estrogen
  • Receptors, Progesterone
  • ERBB2 protein, human
  • Receptor, ErbB-2