Long-term outcomes of ductal carcinoma in situ of the breast: a systematic review, meta-analysis and meta-regression analysis

摘要: To summarize data on long-term ipsilateral local recurrence (LR) and breast cancer death rate (BCDR) for patients with ductal carcinoma in situ (DCIS) who received different treatments. Systematic review study-level meta-analysis of prospective (n = 5) retrospective (n = 21) studies pure DCIS median or mean follow-up time ≥10 years. Meta-regression was performed to assess adjust effects potential confounders – the average age women, period initial treatment, bias duration recurrence- death-rates each treatment group. LR BCDR rates by used were reported. Outside randomized trials, remaining likely have tailored patient according clinical situation. Nine thousand four hundred cases 9391 10-year included. The adjusted meta-regression mastectomy 2.6 % (95 % CI, 0.8–4.5); breast-conserving surgery radiotherapy (RT), 13.6 % 9.8–17.4); without RT, 25.5 % 18.1–32.9); biopsy-only (residual predominately low-grade following inadequate excision), 27.8 % 8.4–47.1). RT + tamoxifen (TAM) conservation (CS) resulted lower compared one no adjuvant treatments: CS + RT + TAM, 9.7 %; CS + RT(no TAM), 14.1 %; CS + TAM(no RT), 24.7 %; CS(alone), 25.1 % (linear trend P < 0.0001). Compared a significantly higher invasive observed odds ratio (OR) 2.61 (P < 0.0001); OR 2.52 (P = 0.001); 1.59 (P = 0.022). similar mastectomy, RT (1.3–2.0 %) non-significantly (2.7 %). Additionally, 15-year reported where all like-studies had ≥ 15-year sets; had meta-analysed total 40.2 % 28.1 %. a ≥ 15-year (that included women metastatic disease) 17.9 %; the ≥ 15-year 55.2 % those LR. More intervention associated greater control at follow-up. For undergoing breast-conservation, when two rather than modalities given.