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Trends in adjuvant therapy after breast-conserving surgery for ductal carcinoma in situ of breast: a retrospective cohort study using the National Breast Cancer Registry of Japan



Radiotherapy (RT) and endocrine therapy (ET) are standard treatment options after breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS). We investigated the national patterns of adjuvant therapy use after BCS for DCIS in Japan.


We obtained relevant data of patients diagnosed with DCIS undergoing surgery and treated with BCS between 2014 and 2016 from the Japanese Breast Cancer Registry database. The relationship between the clinicopathologic, institutional, and regional factors, and adjuvant treatment was examined using multivariable analyses.


We identified 9516 patients who underwent BCS for DCIS. Overall, 23% received no adjuvant treatment, 71% received RT, 32% received ET, and 26% received combination therapy. The percentages of patients who received ET and combination therapy in 2016 were significantly lower [odds ratio (OR): 0.71, 0.77, respectively] than in 2014. The proportion of RT was low among young or elderly patients (OR: 0.75, 0.44, respectively) and in non-certified facilities (OR: 0.56). The proportion of ET was high in non-certified facilities (OR: 1.58) and among patients with positive margins (OR: 1.62). Combination therapy was higher among patients with positive margins (OR: 1.53).


Our study found a distinct adjuvant treatment pattern after BCS for DCIS depending on clinicopathologic factors, year, age, which indicate that physicians provide individualized treatment according to the background of the patients and the biology of DCIS. The facilities and regions remain significant factors of influencing adjuvant treatment pattern.

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Breast-conserving surgery


Ductal carcinoma in situ


Endocrine therapy


Ipsilateral breast tumor recurrence


Japanese Breast Cancer Society




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This report was supported in part by the National Cancer Center Research and Development fund (26-A-4) from the Ministry of Health, Labour and Welfare and the Practical Research for Innovative Cancer Control (19ck0106307h0002) from the Japan Agency for Medical Research and Development, AMED. The grammatical assistance was performed by professional editors at Editage, a division of Cactus Communications (

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Correspondence to Yasuaki Sagara.

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Hiraku Kumamaru and Hiroaki Miyata are affiliated with the department of Healthcare Quality Assessment at the university of Tokyo. The department is a social collaboration department supported by National Clinical Database, Johnson & Johnson K.K., and Nipro Corporation. Naoki Niikura has received grants and personal fees from Chugai, Pfizer, Eisai, Daiichi Sankyo, MSD, grants from Novartis, Eisai, AstraZeneka, Kyowa Hakko Kirin, Nippon Mediphysics, Takeda, Taiho, Nippon Kayaku, Eli Lilly. Hitoshi Tsuda has received grants from Taiho, Goryo Chemical, personal fees and other from Chugai, other from Takeda, Eli Lilly. Yutaka Yamamoto has received grants and personal fees from Chugai, Kyowa Hakko Kirin, Eli Lilly, Nihon Kayaku, personal fees from Taiho, Daiichi Sankyo, AstraZeneca, Novartis, Eisai, Takeda, Pfizer. Naoki Hayashi has received personal fees from Chugai, Novartis, Pfizer, Daiichi Sankyo, AstraZeneca, Genomic Health inc. Minoru Miyashita has received personal fees from Chugai, Eli Lilly, Eisai, AstraZeneca, Pfizer, Taiho, Daiichi Sankyo, non-financial support from Kyowa Hakko Kirin. Kenjiro Aogi has received personal fees as honoraria from Chugai, Eisai, AstraZeneca, Taiho, Novartis, Daiichi Sankyo, Mochida, Ono, Eli Lilly, and his institution received research funds from Chuai, Eisai, Takeda. Shigehira Saji has received grants and personal fees from Chugai, Kyowa Hakko Kirin, Eli Lilly, AstraZeneca, Novartis, Eisai, Takeda, personal fees from Pfizer, MSD, Daiichi Sankyo, grants from Taiho. Masakazu Toi has received grants and personal fees from Chugai, Takeda, Pfizer, Kyowa Hakko Kirin, C & C Res Lab, Taiho, Eisai, Daiichi Sankyo, AstraZeneca, grants from JBCRG association, Astellas, personal fees from Eli Lilly, MSD, Genomic Health, Novartis, Konica Minolta, outside the submitted work; and Board of directors; JBCRG association, Organization for Oncology and Translational Research, Kyoto Breast cancer Research Network. The other authors have no conflict of interest.

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Yotsumoto, D., Sagara, Y., Kumamaru, H. et al. Trends in adjuvant therapy after breast-conserving surgery for ductal carcinoma in situ of breast: a retrospective cohort study using the National Breast Cancer Registry of Japan. Breast Cancer 29, 1–8 (2022).

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  • Ductal carcinoma in situ
  • Adjuvant therapy
  • Radiotherapy
  • Endocrine therapy