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Annals of Surgical Oncology

, Volume 26, Issue 13, pp 4317–4325 | Cite as

Risk of Contralateral Breast Cancer in Women with Ductal Carcinoma In Situ Associated with Synchronous Ipsilateral Lobular Carcinoma In Situ

  • Megan E. Miller
  • Shirin Muhsen
  • Emily C. Zabor
  • Jessica Flynn
  • Cristina Olcese
  • Dilip Giri
  • Kimberly J. Van Zee
  • Melissa PilewskieEmail author
Breast Oncology
  • 124 Downloads

Abstract

Background

Lobular carcinoma in situ (LCIS) is a risk factor for breast cancer, but the effect of LCIS found in association with ductal carcinoma in situ (DCIS) is unknown. In this study, we compared contralateral breast cancer (CBC) and ipsilateral breast tumor recurrence (IBTR) rates among women with DCIS with or without synchronous ipsilateral LCIS treated with breast-conserving surgery (BCS).

Methods

DCIS patients undergoing BCS from 2000 to 2011 with a contralateral breast at risk were stratified by the presence or absence of synchronous ipsilateral LCIS with the index DCIS (DCIS + LCIS vs. DCIS). Those with contralateral, bilateral, or prior ipsilateral LCIS were excluded. Associations of patient, tumor, and treatment factors with CBC and IBTR were evaluated.

Results

Of 1888 patients identified, 1475 (78%) had DCIS and 413 (22%) had DCIS + LCIS. At median follow-up of 7.2 (range 0–17) years, 307 patients had a subsequent first breast event; 207 IBTR and 100 CBC. The 10-year cumulative incidence of IBTR was similar in both groups: 15.0% vs. 14.2% (log-rank, p = 0.8) for DCIS + LCIS vs. DCIS, respectively. The 10-year cumulative incidence of CBC was greater in the DCIS + LCIS group: 10.9% vs. 6.1% for DCIS (log-rank, p < 0.001). After adjustment for other factors, CBC risk remained higher in DCIS + LCIS compared with DCIS (hazard ratio 2.06, 95% confidence interval 1.36–3.11, p = 0.001); there was no significant difference in IBTR risk.

Conclusions

Compared with DCIS alone, DCIS + LCIS is associated with similar IBTR risk but double the risk of CBC. This finding should inform treatment decisions, in particular regarding endocrine therapy for risk reduction.

Notes

Acknowledgment

The preparation of this study was funded in part by NIH/NCI Cancer Center Support Grant No. P30 CA008748 to Memorial Sloan Kettering Cancer Center. This study was presented in poster format at the 41st Annual San Antonio Breast Cancer Symposium, December 4–8, 2018, San Antonio, TX.

Disclosures

Dr. Kimberly J. Van Zee has served on the Advisory Board of Genomic Health.

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Megan E. Miller
    • 1
    • 4
  • Shirin Muhsen
    • 1
    • 5
  • Emily C. Zabor
    • 2
  • Jessica Flynn
    • 2
  • Cristina Olcese
    • 1
  • Dilip Giri
    • 3
  • Kimberly J. Van Zee
    • 1
  • Melissa Pilewskie
    • 1
    Email author
  1. 1.Breast Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Biostatistics Service, Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Department of PathologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Department of SurgeryUniversity Hospitals, Case Western Reserve University School of MedicineClevelandUSA
  5. 5.Clemenceau Medical Center/Johns Hopkins InternationalBeirutLebanon

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