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Endocrine Therapy for Ductal Carcinoma In Situ (DCIS) of the Breast with Breast Conserving Surgery (BCS) and Radiotherapy (RT): a Meta-Analysis

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Pathology & Oncology Research

Abstract

The management of ductal carcinoma in situ (DCIS) with endocrine therapy remains controversial. A meta-analysis was conducted to evaluate the role of endocrine therapy for DCIS with breast conserving surgery (BCS) and radiotherapy (RT). A total of 7 articles with randomized controlled trials were included. Five articles compared the effects of BCS and RT followed by tamoxifen (TAM) or not (BCS + RT + TAM vs BCS + RT) and 2 compared the effects of TAM and anastrozole (ANA). TAM obviously reduced the rates of recurrence of ipsilateral breast cancer (IBCR), recurrence of contralateral breast cancer (CBCR), recurrence of ipsilateral invasive breast cancer (IBCR-INV) and recurrence of contralateral DCIS (CBCR-DCIS), and increased the rate of event-free survival (EFS). While ANA reduced the rates of CBCR and recurrence of contralateral invasive breast cancer (CBCR-INV). Patients with ANA had higher incidence of arthralgia, osteoporosis, hypercholesteremia, headache and vaginal dryness, but lower incidence of deep-vein thrombosis, pulmonary embolism, vasomotor or gynaecological, hot flushes, vaginal haemorrhage, vaginal discharge and vaginal candidiasis than TAM. In conclusion, DCIS patients with positive hormone receptors should be recommended to receive endocrine therapy. Selection of TAM or ANA is based on clinical characteristics and underlying disease of patients, as well as the side-effects of drugs.

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Acknowledgments

The work was supported by the National Natural Science Foundations of China (Juan Ren, 81772793/H1621, Juan Ren, 31201060/C0709; Juan Ren,30973175/C1701; and Juan Ren, 81172490/H1621); Program for New Century Excellent Talents in University (Juan Ren, NCET-12-0440); Scientific and Technological Research Foundation of Shaanxi Province (Juan Ren, 2012 K13-01-06); Research Foundation of Health Department of Shaanxi Province (Juan Ren, 2010D41); Qing Nian Jiao Shi Gen Zong Ji Hua of Xi’an Jiaotong University (“The Fundamental Research Funds for the Central Universities”) (Juan Ren, 2012). Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University, China (Juan Ren, No. XJTU1AHCR2014-041).

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  1. Yanli Yan and Long Zhang contributed equally to this work.

Authors and Affiliations

  1. Medical School of Xi’an Jiaotong University, Xi’an, 710061, Shaanxi Province, China

    Yanli Yan, Li Tan, Xiaowei Ma, Shuai Shao, Jiaxin Liu, Chaofan Xue & Emmanuel Kwateng Drokow

  2. Department of Radiotherapy, Oncology Department, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province, 710061, People’s Republic of China

    Long Zhang, Xiaozhi Zhang, Xiaoting Shi & Juan Ren

  3. Department of Orthopedics, Xi’an Children Hospital, Xi’an, 710000, Shaanxi Province, China

    Yong Zhang

  4. Department of Surgery, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, Shaanxi Province, China

    Zongfang Li

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  1. Yanli Yan
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Correspondence to Juan Ren.

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Yan, Y., Zhang, L., Tan, L. et al. Endocrine Therapy for Ductal Carcinoma In Situ (DCIS) of the Breast with Breast Conserving Surgery (BCS) and Radiotherapy (RT): a Meta-Analysis. Pathol. Oncol. Res. 26, 521–531 (2020). https://doi.org/10.1007/s12253-018-0553-y

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