ABSTRACT: Risk Factors for Subsequent Invasive Breast Cancer and
Breast Cancer Death after Ductal Carcinoma in Situ
In a case-control study derived from a cohort of 4661 women with
a primary carcinoma in situ of the breast, we investigated age
at diagnosis, mode of detection, tumor characteristics, and primary
therapy, as prognostic factors for developing invasive breast
cancer or dying from breast cancer.
From all of the women with
a primary carcinoma in situ reported to the Swedish Cancer Registry
from 1960 through 1992, we selected as cases all of the women
with a ductal carcinoma in situ who later died of breast cancer
(n = 39) or who developed a subsequent invasive cancer in either
breast (n = 118). From this cohort, we also selected controls
matched to the cases by year of diagnosis and health care region.
We conducted univariate and multivariate analyses to study the
association between risk of invasive cancer or death and the
different risk factors.
Large size, diameter 25 mm [odds ratio
(OR), 3.5; 95% confidence interval (CI), 1.1-11.4] and multifocality
(OR, 3.9; 95% CI, 1.2-12.7) increased the risk of breast
cancer death in univariate analysis.
(OR, 0.1; 95% CI, 0.0-1.0) and mastectomy (OR, 0.1-95%
CI, 0.0-0.5) lowered the risk of an ipsilateral invasive
cancer in multivariate analysis.
The risk pattern by treatment
category differed between those who had an ipsilateral invasive
cancer and those who either had a contralateral cancer or died
from breast cancer.
The driving forces behind local and generalized
disease may differ. Because confounding by indication may influence
the effects of different treatments, the results should be interpreted
[05/18/2001; Cancer Epidemiology, Biomarkers and Prevention]
Am J of Clinical Pathology,
Braz J Med Biol Res, 8/02
The Breast, 12/03
St. Gallen Intl Conf on
Br J Cancer, 3/04
LINK to 2nd Opinion Pathology
for DCIS (two articles)
50th Annual Meeting of
Am Soc of Therapeutic Radiology &
Oncology (ASTRO), September 2008
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