Low-grade screen-detected ductal carcinoma in situ progresses
more slowly than high-grade lesions: evidence from an
international multi-centre study

J 2019

Low-grade screen-detected ductal carcinoma in situ progresses more slowly than high-grade lesions: evidence from an international multi-centre study

PONTI, Antonio; Guglielmo RONCO; Elsebeth LYNGE; Mariano TOMATIS; Ahti ANTTILA et al.

Základní údaje

Originální název

Low-grade screen-detected ductal carcinoma in situ progresses more slowly than high-grade lesions: evidence from an international multi-centre study

Autoři

Vydání

Breast Cancer Research and Treatment, Nizozemí, Springer, 2019, 0167-6806

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.831

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/19:00110970

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Breast cancer screening; Ductal carcinoma in situ; Low-grade DCIS; Overtreatment

Štítky

14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 16. 10. 2019 15:34, Mgr. Tereza Miškechová

Anotace

V originále

Purpose Nuclear grade is an important indicator of the biological behaviour of ductal carcinoma in situ (DCIS). De-escalation of treatment has been suggested for low-grade DCIS. Our aim is to estimate the relative rate of progression of DCIS by nuclear grade by analysing the distribution of nuclear grade by detection at initial or subsequent screening. Methods We asked International Cancer Screening Network sites to complete, based on their screening and clinical databases, an aggregated data file on DCIS detection, diagnosis and treatment. Results Eleven screening programs reported 5068 screen-detected pure DCIS in nearly 7 million screening tests in women 50-69 years of age. For all programs combined, low-grade DCIS were 20.1% (range 11.4-31.8%) of graded DCIS, intermediate grade 31.0% and high grade 48.9%. Detection rates decreased more steeply from initial to subsequent screening in low compared to high-grade DCIS: the ratios of subsequent to initial detection rates were 0.39 for low grade, 0.51 for intermediate grade, and 0.75 for high grade (p < 0.001). Conclusions These results suggest that the duration of the preclinical detectable phase is longer for low than for high-grade DCIS. The findings from this large multi-centre, international study emphasize that the management of low-grade DCIS should be carefully scrutinized in order to minimize overtreatment of screen-detected slow-growing or indolent lesions. The high variation by site in the proportion of low grade suggests that further pathology standardization and training would be beneficial.

Citovat

PONTI, Antonio; Guglielmo RONCO; Elsebeth LYNGE; Mariano TOMATIS; Ahti ANTTILA; Nieves ASCUNCE; Mireille BROEDERS; Jean-Luc BULLIARD; Isabella CASTELLANO; Patricia FITZPATRICK; Alfonso FRIGERIO; Solveig HOFVIND; Ondřej MÁJEK; Nereo SEGNAN a Stephen TAPLIN. Low-grade screen-detected ductal carcinoma in situ progresses more slowly than high-grade lesions: evidence from an international multi-centre study. Breast Cancer Research and Treatment. Nizozemí: Springer, 2019, roč. 177, č. 3, s. 761-765. ISSN 0167-6806. Dostupné z: https://doi.org/10.1007/s10549-019-05333-6.

@article{1569817,
   author = {Ponti, Antonio and Ronco, Guglielmo and Lynge, Elsebeth and Tomatis, Mariano and Anttila, Ahti and Ascunce, Nieves and Broeders, Mireille and Bulliard, JeanandLuc and Castellano, Isabella and Fitzpatrick, Patricia and Frigerio, Alfonso and Hofvind, Solveig and Májek, Ondřej and Segnan, Nereo and Taplin, Stephen},
   article_location = {Nizozemí},
   article_number = {3},
   doi = {https://doi.org/10.1007/s10549-019-05333-6},
   keywords = {Breast cancer screening; Ductal carcinoma in situ; Low-grade DCIS; Overtreatment},
   language = {eng},
   issn = {0167-6806},
   journal = {Breast Cancer Research and Treatment},
   title = {Low-grade screen-detected ductal carcinoma in situ progresses more slowly than high-grade lesions: evidence from an international multi-centre study},
   url = {http://dx.doi.org/10.1007/s10549-019-05333-6},
   volume = {177},
   year = {2019}
}

TY  - JOUR
ID  - 1569817
AU  - Ponti, Antonio - Ronco, Guglielmo - Lynge, Elsebeth - Tomatis, Mariano - Anttila, Ahti - Ascunce, Nieves - Broeders, Mireille - Bulliard, Jean-Luc - Castellano, Isabella - Fitzpatrick, Patricia - Frigerio, Alfonso - Hofvind, Solveig - Májek, Ondřej - Segnan, Nereo - Taplin, Stephen
PY  - 2019
TI  - Low-grade screen-detected ductal carcinoma in situ progresses more slowly than high-grade lesions: evidence from an international multi-centre study
JF  - Breast Cancer Research and Treatment
VL  - 177
IS  - 3
SP  - 761-765
EP  - 761-765
PB  - Springer
SN  - 01676806
KW  - Breast cancer screening
KW  - Ductal carcinoma in situ
KW  - Low-grade DCIS
KW  - Overtreatment
UR  - http://dx.doi.org/10.1007/s10549-019-05333-6
L2  - http://dx.doi.org/10.1007/s10549-019-05333-6
N2  - Purpose Nuclear grade is an important indicator of the biological behaviour of ductal carcinoma in situ (DCIS). De-escalation of treatment has been suggested for low-grade DCIS. Our aim is to estimate the relative rate of progression of DCIS by nuclear grade by analysing the distribution of nuclear grade by detection at initial or subsequent screening. Methods We asked International Cancer Screening Network sites to complete, based on their screening and clinical databases, an aggregated data file on DCIS detection, diagnosis and treatment. Results Eleven screening programs reported 5068 screen-detected pure DCIS in nearly 7 million screening tests in women 50-69 years of age. For all programs combined, low-grade DCIS were 20.1% (range 11.4-31.8%) of graded DCIS, intermediate grade 31.0% and high grade 48.9%. Detection rates decreased more steeply from initial to subsequent screening in low compared to high-grade DCIS: the ratios of subsequent to initial detection rates were 0.39 for low grade, 0.51 for intermediate grade, and 0.75 for high grade (p < 0.001). Conclusions These results suggest that the duration of the preclinical detectable phase is longer for low than for high-grade DCIS. The findings from this large multi-centre, international study emphasize that the management of low-grade DCIS should be carefully scrutinized in order to minimize overtreatment of screen-detected slow-growing or indolent lesions. The high variation by site in the proportion of low grade suggests that further pathology standardization and training would be beneficial.
ER  -

PONTI, Antonio; Guglielmo RONCO; Elsebeth LYNGE; Mariano TOMATIS; Ahti ANTTILA; Nieves ASCUNCE; Mireille BROEDERS; Jean-Luc BULLIARD; Isabella CASTELLANO; Patricia FITZPATRICK; Alfonso FRIGERIO; Solveig HOFVIND; Ondřej MÁJEK; Nereo SEGNAN a Stephen TAPLIN. Low-grade screen-detected ductal carcinoma in situ progresses more slowly than high-grade lesions: evidence from an international multi-centre study. \textit{Breast Cancer Research and Treatment}. Nizozemí: Springer, 2019, roč.~177, č.~3, s.~761-765. ISSN~0167-6806. Dostupné z: https://doi.org/10.1007/s10549-019-05333-6.

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