Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast

N. Davidson, R. Gelber, M. Piccart, G. Pruneri, K. Pritchard, P. Ravdin, J. Robertson, S. Swain, O. Abe, R. Abe, K. Enomoto, K. Kikuchi, H. Koyama, H. Masuda, Y. Nomura, Y. Ohashi, K. Sakai, K. Sugimachi, M. Toi, T. TominagaJ. Uchino, M. Yoshida, J. L. Haybittle, C. F. Leonard, G. Calais, P. Geraud, V. Collett, C. Davies, A. Delmestri, J. Sayer, V. J. Harvey, T. M. Holdaway, R. G. Kay, B. H. Mason, J. F. Forbes, N. Wilcken, T. Bauernhofer, P. Dubsky, C. Fesl, H. Fohler, L. Filipcic, M. Filipits, M. Fridrik, M. Gnant, R. Greil, K. Hegenbarth, R. Jakesz, W. Kwasny, A. Lang, C. Geyer, Early Breast Cancer Trialists’ Collaborative Group (EBCTCG)

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Abstract

Individual patient data were available for all four of the randomized trials that began before 1995, and that compared adjuvant radiotherapy vs no radiotherapy following breast-conserving surgery for ductal carcinoma in situ (DCIS). A total of 3729 women were eligible for analysis. Radiotherapy reduced the absolute 10-year risk of any ipsilateral breast event (ie, either recurrent DCIS or invasive cancer) by 15.2% (SE 1.6%, 12.9% vs 28.1% 2 P <.00001), and it was effective regardless of the age at diagnosis, extent of breast-conserving surgery, use of tamoxifen, method of DCIS detection, margin status, focality, grade, comedonecrosis, architecture, or tumor size. The proportional reduction in ipsilateral breast events was greater in older than in younger women (2P < .0004 for difference between proportional reductions; 10-year absolute risks: 18.5% vs 29.1% at ages <50 years, 10.8% vs 27.8% at ages ≥50 years) but did not differ significantly according to any other available factor. Even for women with negative margins and small low-grade tumors, the absolute reduction in the 10-year risk of ipsilateral breast events was 18.0% (SE 5.5, 12.1% vs 30.1%, 2P = .002). After 10 years of follow-up, there was, however, no significant effect on breast cancer mortality, mortality from causes other than breast cancer, or all-cause mortality.

Original languageEnglish (US)
Pages (from-to)162-177
Number of pages16
JournalJournal of the National Cancer Institute - Monographs
Volume41
DOIs
StatePublished - 2010

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Carcinoma, Intraductal, Noninfiltrating
Breast
Radiotherapy
Segmental Mastectomy
Mortality
Breast Neoplasms
Neoplasms
Adjuvant Radiotherapy
Tamoxifen

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Davidson, N., Gelber, R., Piccart, M., Pruneri, G., Pritchard, K., Ravdin, P., ... Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2010). Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. Journal of the National Cancer Institute - Monographs, 41, 162-177. https://doi.org/10.1093/jncimonographs/lgq039

Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. / Davidson, N.; Gelber, R.; Piccart, M.; Pruneri, G.; Pritchard, K.; Ravdin, P.; Robertson, J.; Swain, S.; Abe, O.; Abe, R.; Enomoto, K.; Kikuchi, K.; Koyama, H.; Masuda, H.; Nomura, Y.; Ohashi, Y.; Sakai, K.; Sugimachi, K.; Toi, M.; Tominaga, T.; Uchino, J.; Yoshida, M.; Haybittle, J. L.; Leonard, C. F.; Calais, G.; Geraud, P.; Collett, V.; Davies, C.; Delmestri, A.; Sayer, J.; Harvey, V. J.; Holdaway, T. M.; Kay, R. G.; Mason, B. H.; Forbes, J. F.; Wilcken, N.; Bauernhofer, T.; Dubsky, P.; Fesl, C.; Fohler, H.; Filipcic, L.; Filipits, M.; Fridrik, M.; Gnant, M.; Greil, R.; Hegenbarth, K.; Jakesz, R.; Kwasny, W.; Lang, A.; Geyer, C.; Early Breast Cancer Trialists’ Collaborative Group (EBCTCG).

In: Journal of the National Cancer Institute - Monographs, Vol. 41, 2010, p. 162-177.

Research output: Contribution to journalArticle

Davidson, N, Gelber, R, Piccart, M, Pruneri, G, Pritchard, K, Ravdin, P, Robertson, J, Swain, S, Abe, O, Abe, R, Enomoto, K, Kikuchi, K, Koyama, H, Masuda, H, Nomura, Y, Ohashi, Y, Sakai, K, Sugimachi, K, Toi, M, Tominaga, T, Uchino, J, Yoshida, M, Haybittle, JL, Leonard, CF, Calais, G, Geraud, P, Collett, V, Davies, C, Delmestri, A, Sayer, J, Harvey, VJ, Holdaway, TM, Kay, RG, Mason, BH, Forbes, JF, Wilcken, N, Bauernhofer, T, Dubsky, P, Fesl, C, Fohler, H, Filipcic, L, Filipits, M, Fridrik, M, Gnant, M, Greil, R, Hegenbarth, K, Jakesz, R, Kwasny, W, Lang, A, Geyer, C & Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) 2010, 'Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast', Journal of the National Cancer Institute - Monographs, vol. 41, pp. 162-177. https://doi.org/10.1093/jncimonographs/lgq039
Davidson, N. ; Gelber, R. ; Piccart, M. ; Pruneri, G. ; Pritchard, K. ; Ravdin, P. ; Robertson, J. ; Swain, S. ; Abe, O. ; Abe, R. ; Enomoto, K. ; Kikuchi, K. ; Koyama, H. ; Masuda, H. ; Nomura, Y. ; Ohashi, Y. ; Sakai, K. ; Sugimachi, K. ; Toi, M. ; Tominaga, T. ; Uchino, J. ; Yoshida, M. ; Haybittle, J. L. ; Leonard, C. F. ; Calais, G. ; Geraud, P. ; Collett, V. ; Davies, C. ; Delmestri, A. ; Sayer, J. ; Harvey, V. J. ; Holdaway, T. M. ; Kay, R. G. ; Mason, B. H. ; Forbes, J. F. ; Wilcken, N. ; Bauernhofer, T. ; Dubsky, P. ; Fesl, C. ; Fohler, H. ; Filipcic, L. ; Filipits, M. ; Fridrik, M. ; Gnant, M. ; Greil, R. ; Hegenbarth, K. ; Jakesz, R. ; Kwasny, W. ; Lang, A. ; Geyer, C. ; Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). / Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. In: Journal of the National Cancer Institute - Monographs. 2010 ; Vol. 41. pp. 162-177.
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abstract = "Individual patient data were available for all four of the randomized trials that began before 1995, and that compared adjuvant radiotherapy vs no radiotherapy following breast-conserving surgery for ductal carcinoma in situ (DCIS). A total of 3729 women were eligible for analysis. Radiotherapy reduced the absolute 10-year risk of any ipsilateral breast event (ie, either recurrent DCIS or invasive cancer) by 15.2{\%} (SE 1.6{\%}, 12.9{\%} vs 28.1{\%} 2 P <.00001), and it was effective regardless of the age at diagnosis, extent of breast-conserving surgery, use of tamoxifen, method of DCIS detection, margin status, focality, grade, comedonecrosis, architecture, or tumor size. The proportional reduction in ipsilateral breast events was greater in older than in younger women (2P < .0004 for difference between proportional reductions; 10-year absolute risks: 18.5{\%} vs 29.1{\%} at ages <50 years, 10.8{\%} vs 27.8{\%} at ages ≥50 years) but did not differ significantly according to any other available factor. Even for women with negative margins and small low-grade tumors, the absolute reduction in the 10-year risk of ipsilateral breast events was 18.0{\%} (SE 5.5, 12.1{\%} vs 30.1{\%}, 2P = .002). After 10 years of follow-up, there was, however, no significant effect on breast cancer mortality, mortality from causes other than breast cancer, or all-cause mortality.",
author = "N. Davidson and R. Gelber and M. Piccart and G. Pruneri and K. Pritchard and P. Ravdin and J. Robertson and S. Swain and O. Abe and R. Abe and K. Enomoto and K. Kikuchi and H. Koyama and H. Masuda and Y. Nomura and Y. Ohashi and K. Sakai and K. Sugimachi and M. Toi and T. Tominaga and J. Uchino and M. Yoshida and Haybittle, {J. L.} and Leonard, {C. F.} and G. Calais and P. Geraud and V. Collett and C. Davies and A. Delmestri and J. Sayer and Harvey, {V. J.} and Holdaway, {T. M.} and Kay, {R. G.} and Mason, {B. H.} and Forbes, {J. F.} and N. Wilcken and T. Bauernhofer and P. Dubsky and C. Fesl and H. Fohler and L. Filipcic and M. Filipits and M. Fridrik and M. Gnant and R. Greil and K. Hegenbarth and R. Jakesz and W. Kwasny and A. Lang and C. Geyer and {Early Breast Cancer Trialists’ Collaborative Group (EBCTCG)}",
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AU - Gelber, R.

AU - Piccart, M.

AU - Pruneri, G.

AU - Pritchard, K.

AU - Ravdin, P.

AU - Robertson, J.

AU - Swain, S.

AU - Abe, O.

AU - Abe, R.

AU - Enomoto, K.

AU - Kikuchi, K.

AU - Koyama, H.

AU - Masuda, H.

AU - Nomura, Y.

AU - Ohashi, Y.

AU - Sakai, K.

AU - Sugimachi, K.

AU - Toi, M.

AU - Tominaga, T.

AU - Uchino, J.

AU - Yoshida, M.

AU - Haybittle, J. L.

AU - Leonard, C. F.

AU - Calais, G.

AU - Geraud, P.

AU - Collett, V.

AU - Davies, C.

AU - Delmestri, A.

AU - Sayer, J.

AU - Harvey, V. J.

AU - Holdaway, T. M.

AU - Kay, R. G.

AU - Mason, B. H.

AU - Forbes, J. F.

AU - Wilcken, N.

AU - Bauernhofer, T.

AU - Dubsky, P.

AU - Fesl, C.

AU - Fohler, H.

AU - Filipcic, L.

AU - Filipits, M.

AU - Fridrik, M.

AU - Gnant, M.

AU - Greil, R.

AU - Hegenbarth, K.

AU - Jakesz, R.

AU - Kwasny, W.

AU - Lang, A.

AU - Geyer, C.

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