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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2021

01-02-2021 | Radiotherapy | Breast Oncology

Prognostic Score-Based Stratification Analysis Reveals Universal Benefits of Radiotherapy on Lowering the Risk of Ipsilateral Breast Event for Ductal Carcinoma In Situ Patients with Different Risk Levels

Authors: Libo Yang, MD, PhD, Dongli Lu, PhD, Yutian Lai, MD, PhD, Mengjia Shen, MD, PhD, Qiuxiao Yu, PhD, Ting Lei, MD, PhD, Tianjie Pu, MD, PhD, Hong Bu, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2021

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Abstract

Background

We aimed to analyze the effects of radiotherapy (RT) on the incidence rate of ipsilateral breast event (IBE) in ductal carcinoma in situ (DCIS) patients with lumpectomy after being stratified by prognostic score.

Methods

We identified DCIS patients who received lumpectomy, from the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2015. Cumulative incidence functions for competing risk were used to evaluate the effects of RT on IBE risk over time. Three multivariate regression models (weighted, non-weighted, and Fine–Gray) were applied to compare the IBE risk between the RT and non-RT groups after stratifying patients by prognostic score.

Results

Overall, 72,623 DCIS patients were identified from the SEER database and 49,206 (66.8%) patients received RT. During the follow-up period (ranging from 7 to 347 months), the cumulative probability of invasive and in situ IBE was significantly lower in the RT group than in the non-RT group (p < 0.001). After being stratified by prognostic score, the weighted IBE incidence rate increased as the risk level increased (p < 0.050). In multivariate regression models, RT lowered the IBE incidence rate by at least 30% in low-, moderate-, and high-risk DCIS (p < 0.010). In particular, the in situ and invasive IBE incidence rate decreased by over 50% in low-risk DCIS with RT (p < 0.001).

Conclusions

RT is associated with a lowered IBE incidence rate in DCIS patients, regardless of the assigned risk levels for patients. The significant reduction in the IBE incidence rate in low-risk DCIS patients also indicates the potential benefits for recommending RT to such a patient population in clinical practice.
Appendix
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Metadata
Title
Prognostic Score-Based Stratification Analysis Reveals Universal Benefits of Radiotherapy on Lowering the Risk of Ipsilateral Breast Event for Ductal Carcinoma In Situ Patients with Different Risk Levels
Authors
Libo Yang, MD, PhD
Dongli Lu, PhD
Yutian Lai, MD, PhD
Mengjia Shen, MD, PhD
Qiuxiao Yu, PhD
Ting Lei, MD, PhD
Tianjie Pu, MD, PhD
Hong Bu, MD, PhD
Publication date
01-02-2021
Publisher
Springer International Publishing
Keyword
Radiotherapy
Published in
Annals of Surgical Oncology / Issue 2/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-09003-6

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