Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project

on behalf of the Sloane Project Steering Committee; Abeer M. Shaaban; Bridget Hilton; Karen Baker; Elena Provenzano; Shan Cheung; Matthew G. Wallis; Elinor Sawyer; Jeremy S. Thomas; Andrew M. Hanby; Sarah E. Pinder; Alastair M. Thompson

doi:10.1038/s41416-020-01152-5

Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project

on behalf of the Sloane Project Steering Committee, Abeer M. Shaaban^*, Bridget Hilton, Karen Baker, Elena Provenzano, Shan Cheung, Matthew G. Wallis, Elinor Sawyer, Jeremy S. Thomas, Andrew M. Hanby, Sarah E. Pinder, Alastair M. Thompson

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

40 Citations (Scopus)

17 Downloads (Pure)

Abstract

Background: The Sloane audit compares screen-detected ductal carcinoma in situ (DCIS) pathology with subsequent management and outcomes.

Methods: This was a national, prospective cohort study of DCIS diagnosed during 2003–2012.

Results: Among 11,337 patients, 7204 (64%) had high-grade DCIS. Over time, the proportion of high-grade disease increased (from 60 to 65%), low-grade DCIS decreased (from 10 to 6%) and mean size increased (from 21.4 to 24.1 mm). Mastectomy was more common for high-grade (36%) than for low-grade DCIS (15%). Few (6%) patients treated with breast-conserving surgery (BCS) had a surgical margin <1 mm. Of the 9191 women diagnosed in England (median follow-up 9.4 years), 7% developed DCIS or invasive malignancy in the ipsilateral and 5% in the contralateral breast. The commonest ipsilateral event was invasive carcinoma (n = 413), median time 62 months, followed by DCIS (n = 225), at median 37 months. Radiotherapy (RT) was most protective against recurrence for high-grade DCIS (3.2% for high-grade DCIS with RT compared to 6.9% without, compared with 2.3 and 3.0%, respectively, for low/intermediate-grade DCIS). Ipsilateral DCIS events lessened after 5 years, while the risk of ipsilateral invasive cancer remained consistent to beyond 10 years.

Conclusion: DCIS pathology informs patient management and highlights the need for prolonged follow-up of screen-detected DCIS.

Original language	English
Pages (from-to)	1009-1017
Number of pages	9
Journal	British Journal of Cancer
Volume	124
Issue number	5
DOIs	https://doi.org/10.1038/s41416-020-01152-5
Publication status	Published - 17 Nov 2020

Bibliographical note

Funding Information: This work was supported by Public Heath England and, in part, by Cancer Research UK and by KWF Kankerbestrijding (ref. C38317/A24043) who provided funding support for K.C., E.S., A.M.T. and S.E.P.

Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

Publisher Copyright: © 2020, The Author(s).

Citation: Shaaban, A.M., Hilton, B., Clements, K. et al. Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project. Br J Cancer 124, 1009–1017 (2021).

DOI: https://doi.org/10.1038/s41416-020-01152-5

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1038/s41416-020-01152-5Licence: CC BY

Shaaban2020PathologicalFeaturesOf11337PatientsWithPrimaryDuctalBrJCancerFinal published version, 459 KBLicence: CC BY

Cite this

on behalf of the Sloane Project Steering Committee, Shaaban, A. M., Hilton, B., Baker, K., Provenzano, E., Cheung, S., Wallis, M. G., Sawyer, E., Thomas, J. S., Hanby, A. M., Pinder, S. E., & Thompson, A. M. (2020). Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project. British Journal of Cancer, 124(5), 1009-1017. https://doi.org/10.1038/s41416-020-01152-5

@article{19c3a98fe0a14c87a7299bfb8e36b304,

title = "Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project",

abstract = "Background: The Sloane audit compares screen-detected ductal carcinoma in situ (DCIS) pathology with subsequent management and outcomes. Methods: This was a national, prospective cohort study of DCIS diagnosed during 2003–2012. Results: Among 11,337 patients, 7204 (64%) had high-grade DCIS. Over time, the proportion of high-grade disease increased (from 60 to 65%), low-grade DCIS decreased (from 10 to 6%) and mean size increased (from 21.4 to 24.1 mm). Mastectomy was more common for high-grade (36%) than for low-grade DCIS (15%). Few (6%) patients treated with breast-conserving surgery (BCS) had a surgical margin <1 mm. Of the 9191 women diagnosed in England (median follow-up 9.4 years), 7% developed DCIS or invasive malignancy in the ipsilateral and 5% in the contralateral breast. The commonest ipsilateral event was invasive carcinoma (n = 413), median time 62 months, followed by DCIS (n = 225), at median 37 months. Radiotherapy (RT) was most protective against recurrence for high-grade DCIS (3.2% for high-grade DCIS with RT compared to 6.9% without, compared with 2.3 and 3.0%, respectively, for low/intermediate-grade DCIS). Ipsilateral DCIS events lessened after 5 years, while the risk of ipsilateral invasive cancer remained consistent to beyond 10 years. Conclusion: DCIS pathology informs patient management and highlights the need for prolonged follow-up of screen-detected DCIS.",

author = "{on behalf of the Sloane Project Steering Committee} and Shaaban, {Abeer M.} and Bridget Hilton and Karen Baker and Elena Provenzano and Shan Cheung and Wallis, {Matthew G.} and Elinor Sawyer and Thomas, {Jeremy S.} and Hanby, {Andrew M.} and Pinder, {Sarah E.} and Thompson, {Alastair M.}",

note = "Funding Information: This work was supported by Public Heath England and, in part, by Cancer Research UK and by KWF Kankerbestrijding (ref. C38317/A24043) who provided funding support for K.C., E.S., A.M.T. and S.E.P. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article{\textquoteright}s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article{\textquoteright}s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Publisher Copyright: {\textcopyright} 2020, The Author(s). Citation: Shaaban, A.M., Hilton, B., Clements, K. et al. Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project. Br J Cancer 124, 1009–1017 (2021). DOI: https://doi.org/10.1038/s41416-020-01152-5",

year = "2020",

month = nov,

day = "17",

doi = "10.1038/s41416-020-01152-5",

language = "English",

volume = "124",

pages = "1009--1017",

journal = "British Journal of Cancer",

issn = "0007-0920",

publisher = "Springer Nature",

number = "5",

}

on behalf of the Sloane Project Steering Committee, Shaaban, AM, Hilton, B, Baker, K, Provenzano, E, Cheung, S, Wallis, MG, Sawyer, E, Thomas, JS, Hanby, AM, Pinder, SE & Thompson, AM 2020, 'Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project', British Journal of Cancer, vol. 124, no. 5, pp. 1009-1017. https://doi.org/10.1038/s41416-020-01152-5

Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project. / on behalf of the Sloane Project Steering Committee; Shaaban, Abeer M.; Hilton, Bridget et al.
In: British Journal of Cancer, Vol. 124, No. 5, 17.11.2020, p. 1009-1017.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events

T2 - results from the UK Sloane Project

AU - on behalf of the Sloane Project Steering Committee

AU - Shaaban, Abeer M.

AU - Hilton, Bridget

AU - Baker, Karen

AU - Provenzano, Elena

AU - Cheung, Shan

AU - Wallis, Matthew G.

AU - Sawyer, Elinor

AU - Thomas, Jeremy S.

AU - Hanby, Andrew M.

AU - Pinder, Sarah E.

AU - Thompson, Alastair M.

N1 - Funding Information: This work was supported by Public Heath England and, in part, by Cancer Research UK and by KWF Kankerbestrijding (ref. C38317/A24043) who provided funding support for K.C., E.S., A.M.T. and S.E.P. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Publisher Copyright: © 2020, The Author(s). Citation: Shaaban, A.M., Hilton, B., Clements, K. et al. Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project. Br J Cancer 124, 1009–1017 (2021). DOI: https://doi.org/10.1038/s41416-020-01152-5

PY - 2020/11/17

Y1 - 2020/11/17

N2 - Background: The Sloane audit compares screen-detected ductal carcinoma in situ (DCIS) pathology with subsequent management and outcomes. Methods: This was a national, prospective cohort study of DCIS diagnosed during 2003–2012. Results: Among 11,337 patients, 7204 (64%) had high-grade DCIS. Over time, the proportion of high-grade disease increased (from 60 to 65%), low-grade DCIS decreased (from 10 to 6%) and mean size increased (from 21.4 to 24.1 mm). Mastectomy was more common for high-grade (36%) than for low-grade DCIS (15%). Few (6%) patients treated with breast-conserving surgery (BCS) had a surgical margin <1 mm. Of the 9191 women diagnosed in England (median follow-up 9.4 years), 7% developed DCIS or invasive malignancy in the ipsilateral and 5% in the contralateral breast. The commonest ipsilateral event was invasive carcinoma (n = 413), median time 62 months, followed by DCIS (n = 225), at median 37 months. Radiotherapy (RT) was most protective against recurrence for high-grade DCIS (3.2% for high-grade DCIS with RT compared to 6.9% without, compared with 2.3 and 3.0%, respectively, for low/intermediate-grade DCIS). Ipsilateral DCIS events lessened after 5 years, while the risk of ipsilateral invasive cancer remained consistent to beyond 10 years. Conclusion: DCIS pathology informs patient management and highlights the need for prolonged follow-up of screen-detected DCIS.

AB - Background: The Sloane audit compares screen-detected ductal carcinoma in situ (DCIS) pathology with subsequent management and outcomes. Methods: This was a national, prospective cohort study of DCIS diagnosed during 2003–2012. Results: Among 11,337 patients, 7204 (64%) had high-grade DCIS. Over time, the proportion of high-grade disease increased (from 60 to 65%), low-grade DCIS decreased (from 10 to 6%) and mean size increased (from 21.4 to 24.1 mm). Mastectomy was more common for high-grade (36%) than for low-grade DCIS (15%). Few (6%) patients treated with breast-conserving surgery (BCS) had a surgical margin <1 mm. Of the 9191 women diagnosed in England (median follow-up 9.4 years), 7% developed DCIS or invasive malignancy in the ipsilateral and 5% in the contralateral breast. The commonest ipsilateral event was invasive carcinoma (n = 413), median time 62 months, followed by DCIS (n = 225), at median 37 months. Radiotherapy (RT) was most protective against recurrence for high-grade DCIS (3.2% for high-grade DCIS with RT compared to 6.9% without, compared with 2.3 and 3.0%, respectively, for low/intermediate-grade DCIS). Ipsilateral DCIS events lessened after 5 years, while the risk of ipsilateral invasive cancer remained consistent to beyond 10 years. Conclusion: DCIS pathology informs patient management and highlights the need for prolonged follow-up of screen-detected DCIS.

UR - http://www.scopus.com/inward/record.url?scp=85096066870&partnerID=8YFLogxK

U2 - 10.1038/s41416-020-01152-5

DO - 10.1038/s41416-020-01152-5

M3 - Article

C2 - 33199800

AN - SCOPUS:85096066870

SN - 0007-0920

VL - 124

SP - 1009

EP - 1017

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 5

ER -

Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project

Abstract

Bibliographical note

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this