Risk of contralateral breast cancer in women with ductal carcinoma in situ associated with synchronous ipsilateral lobular carcinoma in situ Journal Article


Authors: Miller, M. E.; Muhsen, S.; Zabor, E. C.; Flynn, J.; Olcese, C.; Giri, D.; Van Zee, K. J.; Pilewskie, M.
Article Title: Risk of contralateral breast cancer in women with ductal carcinoma in situ associated with synchronous ipsilateral lobular carcinoma in situ
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. © 2019, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 26
Issue: 13
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2019-12-01
Start Page: 4317
End Page: 4325
Language: English
DOI: 10.1245/s10434-019-07796-9
PUBMED: 31552614
PROVIDER: scopus
PMCID: PMC6868341
DOI/URL:
Notes: Article -- Export Date: 2 December 2019 -- Source: Scopus
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MSK Authors
  1. Kimberly J Van Zee
    256 Van Zee
  2. Dilip D Giri
    139 Giri
  3. Emily Craig Zabor
    156 Zabor
  4. Shirin Muhsen
    29 Muhsen
  5. Cristina Olcese
    23 Olcese
  6. Megan Elizabeth Miller
    3 Miller
  7. Jessica Flynn
    25 Flynn