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.

Basic information

Original name

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

Authors

PONTI, Antonio (380 Italy, guarantor), Guglielmo RONCO (380 Italy), Elsebeth LYNGE (208 Denmark), Mariano TOMATIS (380 Italy), Ahti ANTTILA (246 Finland), Nieves ASCUNCE (724 Spain), Mireille BROEDERS (528 Netherlands), Jean-Luc BULLIARD (756 Switzerland), Isabella CASTELLANO (380 Italy), Patricia FITZPATRICK (372 Ireland), Alfonso FRIGERIO (380 Italy), Solveig HOFVIND (578 Norway), Ondřej MÁJEK (203 Czech Republic, belonging to the institution), Nereo SEGNAN (380 Italy) and Stephen TAPLIN (840 United States of America)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.831

RIV identification code

RIV/00216224:14110/19:00110970

Organization unit

Faculty of Medicine

DOI

UT WoS

000485999300023

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 16/10/2019 15:34, Mgr. Tereza Miškechová

Abstract

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.