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 and 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, vol. 177, No 3, p. 761-765. ISSN 0167-6806. Available from: https://dx.doi.org/10.1007/s10549-019-05333-6.
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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
Original language English
Type of outcome Article in a journal
Field of Study 30204 Oncology
Country of publisher United Kingdom of Great Britain and Northern Ireland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 3.831
RIV identification code RIV/00216224:14110/19:00110970
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1007/s10549-019-05333-6
UT WoS 000485999300023
Keywords in English Breast cancer screening; Ductal carcinoma in situ; Low-grade DCIS; Overtreatment
Tags 14119612, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 16/10/2019 15:34.
Abstract
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.
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