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. 2022 Jul;11(14):2755-2766.
doi: 10.1002/cam4.4651. Epub 2022 May 22.

Molecular subtypes predict second breast events of ductal carcinoma in situ after breast-conserving surgery

Yilan Yang  1   2   3 , Xu Zhao  1   2   3 , Xuanyi Wang  1   2   3 , Kairui Jin  1   2   3 , Jurui Luo  1   2   3 , Zhaozhi Yang  1   2   3 , Xin Mei  1   2   3 , Jinli Ma  1   2   3 , Zhimin Shao  2   4 , Zhen Zhang  1   2   3 , Xingxing Chen  1   2   3 , Xiaomao Guo  1   2   3 , Xiaoli Yu  1   2   3
Affiliations

Molecular subtypes predict second breast events of ductal carcinoma in situ after breast-conserving surgery

Yilan Yang et al. Cancer Med. 2022 Jul.

Abstract

Purpose: Currently, the prognostic value of molecular subtypes in ductal carcinoma in situ (DCIS) remains unclear. In this study, we explored whether molecular subtypes could predict second breast events (SBEs) in patients after breast-conserving surgery (BCS).

Methods: From January 2008 to December 2016, 291 DCIS patients treated with BCS were retrospectively analyzed. Patients were classified into four molecular subtypes: luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) overexpression, and triple-negative breast cancer (TNBC). The SBE incidence was calculated by the competing risk model and compared by Gray's test. The disease-free survival rates were estimated by the Kaplan-Meier method and compared by the log-rank test. Prognostic factors were evaluated by univariate and multivariate COX proportional hazards regression model.

Results: With a median follow-up of 66 months, 12 SBEs were identified. The 5-year overall SBE incidence of luminal A, luminal B, HER2 overexpression, and TNBC was 2.18%, 4.25%, 15.15%, and 0.00%, respectively. In the univariate analysis, the HER2 overexpression subtype was the predictor of overall (p = 0.005), in situ (p = 0.004), and ipsilateral SBEs (p = 0.008). Patients with endocrine therapy were less likely to develop in situ SBEs (p = 0.039). Additionally, patients with closed (<2 mm) or involved margins were related to a higher risk of contralateral SBEs (p = 0.029). In the multivariate analysis, the HER2 overexpression subtype remained of prognostic values for overall (p = 0.006), in situ (p = 0.029), and ipsilateral SBEs (p = 0.012).

Conclusions: The molecular subtype, especially the HER2 overexpression subtype, was the independent prognostic factor for DCIS patients who underwent BCS.

Keywords: DCIS; HER2 overexpression; molecular subtypes; second breast events.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Cumulative incidence of (A) overall SBEs, (B) in situ SBEs, and (C) ipsilateral SBEs by molecular subtypes. HER2+, HER2 overexpression; TNBC, triple‐negative breast cancer
FIGURE 2
FIGURE 2
Kaplan–Meier curves of disease‐free survival by molecular subtypes. HER2+, HER2 overexpression; TNBC, triple‐negative breast cancer
FIGURE 3
FIGURE 3
Kaplan–Meier curves of disease‐free survival by radiotherapy
See this image and copyright information in PMC

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References

    1. Allred DC. Ductal carcinoma in situ: terminology, classification, and natural history. J Natl Cancer Inst Monogr. 2010;2010(41):134‐138. - PMC - PubMed
    1. DeSantis CE, Ma J, Gaudet MM, et al. Breast cancer statistics, 2019. CA Cancer J Clin. 2019;69(6):438‐451. - PubMed
    1. Li C, Yang Y, Wang J, et al. Characteristics, prognosis, risk factors, and management of recently diagnosed ductal carcinoma in situ with microinvasion. Cancer Med. 2021;10(20):7203‐7212. - PMC - PubMed
    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71(1):7‐33. - PubMed
    1. Narod SA, Iqbal J, Giannakeas V, Sopik V, Sun P. Breast cancer mortality after a diagnosis of ductal carcinoma in situ. JAMA Oncol. 2015;1(7):888‐896. - PubMed

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