World J Breast Cancer Res | Volume 4, Issue 1 | Research Article | Open Access

Does Concomitant DCIS Affect the Clinical Outcome in Breast Cancer Patients with Invasive Ductal Carcinoma: An Asian Perspective?

Lee WP1*, Shetty SS1, Seah CMJ1, Tan PT2 and Tan SM1

1Division of Breast Surgery, Department of Surgery, Changi General Hospital, Singapore
2Clinical Trials and Research Unit, Changi General Hospital, Singapore

*Correspondance to: Wai Peng Lee 

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Abstract

Background: Ductal Carcinoma in Situ (DCIS) is an established precursor to Invasive Ductal Carcinoma (IDC) and its coexistence with IDC appear to favor reduced biological aggressiveness. Its prognostic implication and ability to affect clinical outcome has been understudied in Asia. This study aims to explore if concomitant DCIS affects the clinical behavior and outcomes among Asians. Methods: Stage I to III breast cancer patients with histologically proven invasive ductal carcinoma, diagnosed and treated in a single institution from 1 June 2004 to 30 June 2014 were included in this study. Statistical analyses were conducted using χ2 test, independent T- test, and multivariate logistic regression and Kaplan-Meier test. Results: A total of 818 patients were identified, including 224 and 594 patients with isolated IDC (No-DCIS) and IDC with coexisting DCIS (IDC-DCIS) respectively. Patients with IDC-DCIS were found to have smaller tumors (median: 22 mm, p=0.01), estrogen receptor positivity (p=0.001), progesterone receptor positivity (p<0.001) and associated with better pathological stage (p=0.001). Patients with No-DCIS were 1.6 times more likely to develop disease progression (95% CI: 1.1 to 2.3, p=0.027) and subsequently associated with distant recurrences (20.5% vs. 13.6%, p=0.02). The breast cancer specific 5 year overall survival rate for patients with No-DCIS and those with IDC-DCIS was 90.9% (95% CI: 86.2% to 94.5%) and 93.7% (95% CI: 91.4 to 95.5%) respectively (p=0.202). Conclusion: The presence of DCIS component in IDC among Asians is associated with favourable tumor biological profile, thereby indicating reduced disease aggressiveness. Our study is the first to report the clinical significance in terms of disease progression and distant recurrences among Asians.

Keywords:

Ductal Carcinoma in Situ (DCIS), Breast cancer,Sentinel Lymph Node Biopsy,

Citation:

Lee WP, Shetty SS, Seah CMJ, Tan PT, Tan SM. Does Concomitant DCIS Affect the Clinical Outcome in Breast Cancer Patients with Invasive Ductal Carcinoma: An Asian Perspective?. World J Breast Cancer Res. 2021; 4(1): 1021..

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