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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2022

12-08-2022 | Mastectomy | Breast Oncology

Clinicopathologic Features, Treatment Patterns, and Disease Outcomes in a Modern, Prospective Cohort of Young Women Diagnosed with Ductal Carcinoma In Situ

Authors: Megan E. Tesch, MD, Shoshana M. Rosenberg, ScD, MPH, Laura C. Collins, MD, Julia S. Wong, MD, Laura Dominici, MD, Kathryn J. Ruddy, MD, MPH, Rulla Tamimi, ScD, Lidia Schapira, MD, Virginia F. Borges, MD, MMSc, Ellen Warner, MD, MSc, Steven E. Come, MD, Ann H. Partridge, MD, MPH

Published in: Annals of Surgical Oncology | Issue 13/2022

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Abstract

Background

Ductal carcinoma in situ (DCIS) is uncommon and understudied in young women. The objective of this study is to describe clinicopathologic features, treatment, and oncologic outcomes in a modern cohort of women aged ≤ 40 years with DCIS.

Patients and Methods

Patients with DCIS were identified from the Young Women’s Breast Cancer Study, a multisite prospective cohort of women diagnosed with stage 0–IV breast cancer at age ≤ 40 years, enrolled from 2006 to 2016. Clinical data were collected from patient surveys and medical records. Pathologic features were examined by central review. Data were summarized with descriptive statistics and groups were compared with χ2 and Fisher’s exact tests.

Results

Among the 98 patients included, median age of diagnosis was 38 years; 36 (37%) patients were symptomatic on presentation. DCIS nuclear grade was high in 35%, intermediate in 50%, and low in 15% of lesions; 36% of lesions had comedonecrosis. The majority of patients underwent bilateral mastectomy (57%), 16 (16%) underwent unilateral mastectomy, and 26 (27%) underwent lumpectomy, most of whom received radiation. Few (13%) patients were receiving tamoxifen therapy 1 year postdiagnosis. Over a median follow-up of 8.4 years, six patients (6%) had disease recurrence, including five locoregional and one distant event.

Conclusions

A high proportion of young women with DCIS underwent mastectomy with or without contralateral prophylactic mastectomy. Although DCIS was frequently symptomatic on presentation and exhibited unfavorable pathologic factors, clinicopathologic features were overall heterogeneous and few recurrences occurred. This underscores the need for careful consideration of treatment options in young women with DCIS.
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Metadata
Title
Clinicopathologic Features, Treatment Patterns, and Disease Outcomes in a Modern, Prospective Cohort of Young Women Diagnosed with Ductal Carcinoma In Situ
Authors
Megan E. Tesch, MD
Shoshana M. Rosenberg, ScD, MPH
Laura C. Collins, MD
Julia S. Wong, MD
Laura Dominici, MD
Kathryn J. Ruddy, MD, MPH
Rulla Tamimi, ScD
Lidia Schapira, MD
Virginia F. Borges, MD, MMSc
Ellen Warner, MD, MSc
Steven E. Come, MD
Ann H. Partridge, MD, MPH
Publication date
12-08-2022
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2022
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-12361-y

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