1 / 7

Rahul R. Parikh, MD 1 , Bruce G. Haffty, MD 1 , & Meena S. Moran, MD 2

Presentation No: 1083. Ductal Carcinoma in Situ with Microinvasion: Prognostic Implications, Long-term Outcomes, and Role of Axillary Evaluation. Rahul R. Parikh, MD 1 , Bruce G. Haffty, MD 1 , & Meena S. Moran, MD 2.

ethel
Télécharger la présentation

Rahul R. Parikh, MD 1 , Bruce G. Haffty, MD 1 , & Meena S. Moran, MD 2

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Presentation No: 1083 Ductal Carcinoma in Situ with Microinvasion: Prognostic Implications, Long-term Outcomes, and Role of Axillary Evaluation Rahul R. Parikh, MD1, Bruce G. Haffty, MD1, & Meena S. Moran, MD2 1Department of Radiation Oncology, The Cancer Institute of New Jersey, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 2 Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT Yale School of Medicine

  2. Purpose/Methods • DCIS has a relatively good prognosis with breast conserving surgery and radiation (CS+RT). • Axillary evaluation is not routinely performed for pure DCIS lesions because of the low prevalence of nodal metastases (0-7%). • The role for surgical exploration of the axilla remains unclear for patients with DCIS with microinvasion (DCISM).    • We assessed the association of age, race, family history, margin status, histology, and receptor status, with DCIS or DCISM in a large cohort of patients treated with CS+RT (n=393).  • Long-term outcome was evaluated as a function pathology (DCIS vs. DCISM) and axillary evaluation for LRFS, DMFS, and OS. • Median patient age at diagnosis = 55.8 years • Median follow-up = 12.91 years 

  3. Extent of Axillary Evaluation * Note: All patients that had SLNBx went on to have Axillary dissection (standard clinical practice during this time interval)

  4. Patient/Tumor Characteristics • DCISM did NOT correlate with, young age, race, family history, margin status, histology, receptor status, use of hormonal therapy or chemotherapy. • (all p > 0.05)

  5. Univariate survival analysis In UVA, margin status, histology, pathology, and axillary evaluation were NOT independent predictors of LRFS, DMFS, or OS (p > 0.05).

  6. Survival Figure 2. 10-year DMFS for DCIS = 98.5% & DCISM = 97.9% (p = 0.77, log-rank test). Figure 1. 10 year LRFS for DCIS = 90.7% & DCISM = 89.0% (p = 0.36, log-rank test). Figure 3. 10-year OS for DCIS = 93.2% & DCISM = 95.7% (p = 0.93, log-rank test).

  7. Conclusions • DCISM did NOT correlate with local relapse, young age, race, family history, margin status, histology, or adjuvant therapy (all p> 0.05). • Similar to DCIS, the prevalence of nodal metastases in the DCISM cohort was low (1.38%) in this large dataset. • In UVA & survival analysis, pathology (DCIS vs. DCISM) was NOT an independent predictor of LRFS, DMFS, or OS (p > 0.05). • Surgical evaluation of the axilla was NOT an independent predictor of LRFS, DMFS, or OS in Cox proportional hazards analysis (p > 0.05). • Given the low incidence of loco-regional and distant failures in this large, retrospective dataset, the role for surgical evaluation of the axilla remains unclear. • TAKE HOME POINT: Patients with DCISM may be treated similarly to patients with DCIS. Yale School of Medicine

More Related