Management of breast ductal carcinoma in situ in Catalonia, Spain: Results from the Grup Oncologic Calalà-Occità-Catalonia survey with 9-year follow up. (October 2017)

• Record Type: Journal Article
• Authors: Cambra, M.J.; Farrús, B.; Moreno, F.; Anglada, Ll; Arenas, M.; Ballester, R.; Casals, J.; Cusidó, M.; García, V.; Gutiérrez, C.; Mollà, M.; Pedro, A.; Reyes, V.; Sanz, X.
• Is Part Of: Breast. Volume 35(2017)
• Page Start: 196
• Page End: 202
• Publication Date: 2017-10
• Subjects: Breast cancer -- Ductal carcinoma in situ -- Patterns of care -- Outcome -- Survey; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2017.08.002
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: Introduction: Reliable data on DCIS incidence and management are not available in many countries. The present study describes the management of DCIS in Catalonia, Spain in the year 2005 and compares these findings to data obtained in France. Local recurrence and late toxicity rates from 2005 through the end of 2014 are reported. Materials and methods: Observational survey of patients with pure DCIS (n = 270) diagnosed during 2005. A written questionnaire, the same as used in the French survey, was completed by 14 doctors at 12 cancer centres in Catalonia, Spain. Results: Median patient age was 55 years (range, 29–89). Diagnosis was mammographic in 225 cases (83.3%). Treatment approaches included: mastectomy (10.4% of cases), breast-conserving surgery (BCS) alone (3.7%), and BCS plus radiotherapy (RT) (85.5%). Sentinel node biopsy and axillary dissection were performed in 27.4% and 5.6% of patients, respectively. Hormonotherapy was prescribed in 45.2% of cases. Tumour nuclear grade was as follows: low (16.7% of cases), intermediate (23%), and high (55.6%). Excision was complete (margins ≥1 mm) in 75% of patients treated with BCS alone vs. 95.7% for BCS+RT. The treatment approach varied widely: mastectomy rates ranged from 7.1% to 26.7% of centres, BCS+RT from 55.5% to 87.8%, and hormonotherapy from 3.3% to 83.3%. At a median follow-up of 102.6 months, 14 patients (5.6%) presented ipsilateral breast tumour recurrence. Conclusions: These findings on DCIS management in Catalonia are consistent with previous international reports. The inter-centre differences observed are similar to those reported in other international surveys during the same period. Highlights: The incidence of DCIS has increased since the implementation of breast cancer screening programs. Reliable population-based data are not available in many countries, including Spain. The findings provide insight into the wide inter-centre variation in management of DCIS in Catalonia, Spain. The present study is the first DCIS management observational comparative survey conducted in Spain.