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Nguyen AT, Curtis KM, Tepper NK, Kortsmit K, Brittain AW, Snyder EM, Cohen MA, Zapata LB, Whiteman MK. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep 2024; 73:1-126. [PMID: 39106314 PMCID: PMC11315372 DOI: 10.15585/mmwr.rr7304a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024] Open
Abstract
The 2024 U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) comprises recommendations for the use of specific contraceptive methods by persons who have certain characteristics or medical conditions. These recommendations for health care providers were updated by CDC after review of the scientific evidence and a meeting with national experts in Atlanta, Georgia, during January 25-27, 2023. The information in this report replaces the 2016 U.S. MEC (CDC. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR 2016:65[No. RR-3]:1-103). Notable updates include 1) the addition of recommendations for persons with chronic kidney disease; 2) revisions to the recommendations for persons with certain characteristics or medical conditions (i.e., breastfeeding, postpartum, postabortion, obesity, surgery, deep venous thrombosis or pulmonary embolism with or without anticoagulant therapy, thrombophilia, superficial venous thrombosis, valvular heart disease, peripartum cardiomyopathy, systemic lupus erythematosus, high risk for HIV infection, cirrhosis, liver tumor, sickle cell disease, solid organ transplantation, and drug interactions with antiretrovirals used for prevention or treatment of HIV infection); and 3) inclusion of new contraceptive methods, including new doses or formulations of combined oral contraceptives, contraceptive patches, vaginal rings, progestin-only pills, levonorgestrel intrauterine devices, and vaginal pH modulator. The recommendations in this report are intended to serve as a source of evidence-based clinical practice guidance for health care providers. The goals of these recommendations are to remove unnecessary medical barriers to accessing and using contraception and to support the provision of person-centered contraceptive counseling and services in a noncoercive manner. Health care providers should always consider the individual clinical circumstances of each person seeking contraceptive services. This report is not intended to be a substitute for professional medical advice for individual patients; when needed, patients should seek advice from their health care providers about contraceptive use.
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Affiliation(s)
- Antoinette T. Nguyen
- Division of Reproductive Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Kathryn M. Curtis
- Division of Reproductive Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Naomi K. Tepper
- Division of Reproductive Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Katherine Kortsmit
- Division of Reproductive Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Anna W. Brittain
- Division of Reproductive Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Emily M. Snyder
- Division of Reproductive Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Megan A. Cohen
- Division of Reproductive Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Lauren B. Zapata
- Division of Reproductive Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Maura K. Whiteman
- Division of Reproductive Health, National Center for
Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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Timbres J, Kohut K, Caneppele M, Troy M, Schmidt MK, Roylance R, Sawyer E. DCIS and LCIS: Are the Risk Factors for Developing In Situ Breast Cancer Different? Cancers (Basel) 2023; 15:4397. [PMID: 37686673 PMCID: PMC10486708 DOI: 10.3390/cancers15174397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/09/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Ductal carcinoma in situ (DCIS) is widely accepted as a precursor of invasive ductal carcinoma (IDC). Lobular carcinoma in situ (LCIS) is considered a risk factor for invasive lobular carcinoma (ILC), and it is unclear whether LCIS is also a precursor. Therefore, it would be expected that similar risk factors predispose to both DCIS and IDC, but not necessarily LCIS and ILC. This study examined associations with risk factors using data from 3075 DCIS cases, 338 LCIS cases, and 1584 controls aged 35-60, recruited from the UK-based GLACIER and ICICLE case-control studies between 2007 and 2012. Analysis showed that breastfeeding in parous women was protective against DCIS and LCIS, which is consistent with research on invasive breast cancer (IBC). Additionally, long-term use of HRT in post-menopausal women increased the risk of DCIS and LCIS, with a stronger association in LCIS, similar to the association with ILC. Contrary to findings with IBC, parity and the number of births were not protective against DCIS or LCIS, while oral contraceptives showed an unexpected protective effect. These findings suggest both similarities and differences in risk factors for DCIS and LCIS compared to IBC and that there may be justification for increased breast surveillance in post-menopausal women taking long-term HRT.
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Affiliation(s)
- Jasmine Timbres
- Breast Cancer Genetics, King’s College London, London SE1 9RT, UK
| | - Kelly Kohut
- St George’s University Hospitals NHS Foundation Trust, Blackshaw Rd, London SW17 0QT, UK
| | | | - Maria Troy
- Guy’s and St Thomas’ NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK
| | - Marjanka K. Schmidt
- Division of Molecular Pathology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Clinical Genetics, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
| | - Rebecca Roylance
- University College London Hospitals NHS Foundation Trust, 235 Euston Rd., London NW1 2BU, UK
| | - Elinor Sawyer
- Breast Cancer Genetics, King’s College London, London SE1 9RT, UK
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Cohen SY, Stoll CR, Anandarajah A, Doering M, Colditz GA. Modifiable risk factors in women at high risk of breast cancer: a systematic review. Breast Cancer Res 2023; 25:45. [PMID: 37095519 PMCID: PMC10123992 DOI: 10.1186/s13058-023-01636-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/11/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Modifiable risk factors (alcohol, smoking, obesity, hormone use, and physical activity) affect a woman's breast cancer (BC) risk. Whether these factors affect BC risk in women with inherited risk (family history, BRCA1/2 mutations, or familial cancer syndrome) remains unclear. METHODS This review included studies on modifiable risk factors for BC in women with inherited risk. Pre-determined eligibility criteria were used and relevant data were extracted. RESULTS The literature search resulted in 93 eligible studies. For women with family history, most studies indicated that modifiable risk factors had no association with BC and some indicated decreased (physical activity) or increased risk (hormonal contraception (HC)/menopausal hormone therapy (MHT), smoking, alcohol). For women with BRCA mutations, most studies reported no association between modifiable risk factors and BC; however, some observed increased (smoking, MHT/HC, body mass index (BMI)/weight) and decreased risk (alcohol, smoking, MHT/HC, BMI/weight, physical activity). However, measurements varied widely among studies, sample sizes were often small, and a limited number of studies existed. CONCLUSIONS An increasing number of women will recognize their underlying inherited BC risk and seek to modify that risk. Due to heterogeneity and limited power of existing studies, further studies are needed to better understand how modifiable risk factors influence BC risk in women with inherited risk.
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Affiliation(s)
- Sarah Y. Cohen
- Washington University in St. Louis School of Medicine, St. Louis, MO USA
| | - Carolyn R. Stoll
- Washington University in St. Louis School of Medicine, St. Louis, MO USA
| | - Akila Anandarajah
- Washington University in St. Louis School of Medicine, St. Louis, MO USA
| | - Michelle Doering
- Washington University in St. Louis School of Medicine, St. Louis, MO USA
| | - Graham A. Colditz
- Washington University in St. Louis School of Medicine, St. Louis, MO USA
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Grandi G, Toss A, Cagnacci A, Marcheselli L, Pavesi S, Facchinetti F, Cascinu S, Cortesi L. Combined Hormonal Contraceptive Use and Risk of Breast Cancer in a Population of Women With a Family History. Clin Breast Cancer 2017; 18:e15-e24. [PMID: 29150351 DOI: 10.1016/j.clbc.2017.10.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/08/2017] [Accepted: 10/18/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND We estimated the association between combined hormonal contraceptive (CHC) use and breast cancer (BC) incidence in a well-selected population of women at familial risk of BC at the Modena Family Cancer Clinic. MATERIALS AND METHODS We performed a retrospective cohort study by reviewing the data from 2527 women (4.5% BRCA mutation carriers, 72.2% high risk, and 23.3% intermediate risk using the Modena criteria and the Tyrer-Cuzick model). RESULTS We did not find any specific feature of breast cancer (infiltration, hormone receptor and HER2 status, onset before age 35 years, multiple diagnoses) in the CHC users (P > .05). Only 2.0% of women used a preparation with ≥ 50 μg of ethinylestradiol (EE). The use of CHCs was not associated with an increased risk of breast cancer (cumulative hazard: never used, 0.17; CHC users, 0.20; P = .998), regardless of the duration of use (cumulative hazard: never used, 0.17, used < 5 years, 0.20; used 5-10 years, 0.14; used > 10 years, 0.25; P = .414). This was confirmed for the different risk groups when interacted in a Cox proportional hazard regression model. The EE dose did not influence the risk of BC (cumulative hazard, 2.37; 95% confidence interval, 0.53-10.1; never used, 0.18; EE < 20 μg used, 0.04; EE ≥ 20 μg used, 0.16; P = .259). The types of progestins used might influence the risk, with some, such as gestodene (P = .028) and cyproterone acetate (P = .031), associated with an even greater reduced risk. CONCLUSIONS CHC use does not increase the risk of BC in a population of women with a family history, encouraging CHC use in this group of women.
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Affiliation(s)
- Giovanni Grandi
- Department of Obstetrics, Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero-Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy.
| | - Angela Toss
- Department of Oncology, Haematology and Respiratory Disease, Azienda Ospedaliero-Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - Angelo Cagnacci
- Obstetrics and Gynecology Unit, University of Udine, Udine, Italy
| | - Luigi Marcheselli
- Department of Oncology, Haematology and Respiratory Disease, Azienda Ospedaliero-Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Pavesi
- Department of Obstetrics, Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero-Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - Fabio Facchinetti
- Department of Obstetrics, Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero-Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Cascinu
- Department of Oncology, Haematology and Respiratory Disease, Azienda Ospedaliero-Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Cortesi
- Department of Oncology, Haematology and Respiratory Disease, Azienda Ospedaliero-Universitaria Policlinico, University of Modena and Reggio Emilia, Modena, Italy
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Kantor O, Winchester DJ. Breast conserving therapy for DCIS-Does size matter? J Surg Oncol 2014; 110:75-81. [DOI: 10.1002/jso.23657] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 04/26/2014] [Indexed: 12/27/2022]
Affiliation(s)
- Olga Kantor
- University of Chicago, Pritzker School of Medicine; Chicago Illinois
| | - David J. Winchester
- University of Chicago, Pritzker School of Medicine; Chicago Illinois
- NorthShore University HealthSystem; Evanston Illinois
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Anothaisintawee T, Wiratkapun C, Lerdsitthichai P, Kasamesup V, Wongwaisayawan S, Srinakarin J, Hirunpat S, Woodtichartpreecha P, Boonlikit S, Teerawattananon Y, Thakkinstian A. Risk factors of breast cancer: a systematic review and meta-analysis. Asia Pac J Public Health 2013; 25:368-87. [PMID: 23709491 DOI: 10.1177/1010539513488795] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The etiology of breast cancer might be explained by 2 mechanisms, namely, differentiation and proliferation of breast epithelial cells mediated by hormonal factors. We performed a systematic review and meta-analysis to update effects of risk factors for both mechanisms. MEDLINE and EMBASE were searched up to January 2011. Studies that assessed association between oral contraceptives (OC), hormonal replacement therapy (HRT), diabetes mellitus (DM), or breastfeeding and breast cancer were eligible. Relative risks with their confidence intervals (CIs) were extracted. A random-effects method was applied for pooling the effect size. The pooled odds ratios of OC, HRT, and DM were 1.10 (95% CI = 1.03-1.18), 1.23 (95% CI = 1.21-1.25), and 1.14 (95% CI = 1.09-1.19), respectively, whereas the pooled odds ratio of ever-breastfeeding was 0.72 (95% CI = 0.58-0.89). Our study suggests that OC, HRT, and DM might increase risks, whereas breastfeeding might lower risks of breast cancer.
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Badruddoja M. Ductal carcinoma in situ of the breast: a surgical perspective. Int J Surg Oncol 2012; 2012:761364. [PMID: 22988495 PMCID: PMC3440876 DOI: 10.1155/2012/761364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 04/09/2012] [Accepted: 05/07/2012] [Indexed: 12/21/2022] Open
Abstract
Ductal carcinoma in situ (DCIS) of the breast is a heterogeneous neoplasm with invasive potential. Risk factors include age, family history, hormone replacement therapy, genetic mutation, and patient lifestyle. The incidence of DCIS has increased due to more widespread use of screening and diagnostic mammography; almost 80% of cases are diagnosed with imaging with final diagnosis established by biopsy and histological examination. There are various classification systems used for DCIS, the most recent of which is based on the presence of intraepithelial neoplasia of the ductal epithelium (DIN). A number of molecular assays are now available that can identify high-risk patients as well as help establish the prognosis of patients with diagnosed DCIS. Current surgical treatment options include total mastectomy, simple lumpectomy in very low-risk patients, and lumpectomy with radiation. Adjuvant therapy is tailored based on the molecular profile of the neoplasm and can include aromatase inhibitors, anti-estrogen, anti-progesterone (or a combination of antiestrogen and antiprogesterone), and HER2 neu suppression therapy. Chemopreventive therapies are under investigation for DCIS, as are various molecular-targeted drugs. It is anticipated that new biologic agents, when combined with hormonal agents such as SERMs and aromatase inhibitors, may one day prevent all forms of breast cancer.
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Affiliation(s)
- Mohammed Badruddoja
- Department of Surgical Oncology, Rehabilitation Associates of Northern Illinois, Rockford, IL 61111, USA
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Virnig BA, Wang SY, Shamilyan T, Kane RL, Tuttle TM. Ductal carcinoma in situ: risk factors and impact of screening. J Natl Cancer Inst Monogr 2011; 2010:113-6. [PMID: 20956813 DOI: 10.1093/jncimonographs/lgq024] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The National Institutes of Health Office of Medical Applications of Research commissioned a structured literature review on the incidence of ductal carcinoma in situ (DCIS) as a background paper for the State of the Science Conference on Diagnosis and Management of DCIS. METHODS Published studies were abstracted from MEDLINE and other sources. We include articles published through January 31, 2009; 92 publications were abstracted. RESULTS DCIS incidence rose from 1.87 per 100,000 in 1973-1975 to 32.5 per 100,000 in 2005. Increases in incidence were greatest in tumors without comedo necrosis. Incidence increased in all ages but more in women older than 50 years. Increased use of mammography explains some but not all of the increased incidence. Risk factors for incident DCIS include older age and positive family history. Whereas tamoxifen prevents both invasive breast cancer and DCIS, raloxifene is associated with decreased invasive breast cancer but not decreased DCIS. CONCLUSIONS Scientific questions deserving further investigation include the relationship between mammography use and DCIS incidence and the role of chemoprevention for reducing the incidence of DCIS and invasive breast cancer.
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Affiliation(s)
- Beth A Virnig
- Division of Health Policy and Management, School of Public Health, University of Minnesota, A365 Mayo (MMC 729), 420 Delaware St SE, Minneapolis, MN 55455, USA.
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Contraception hormonale. Contraception 2011. [DOI: 10.1016/b978-2-294-70921-0.00006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ductal carcinoma in situ: a challenging disease. Oncol Rev 2010. [DOI: 10.1007/s12156-010-0049-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Oral contraceptives and family history of breast cancer. Contraception 2009; 80:372-80. [DOI: 10.1016/j.contraception.2009.04.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 04/07/2009] [Accepted: 04/07/2009] [Indexed: 11/19/2022]
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Phillips LS, Millikan RC, Schroeder JC, Barnholtz-Sloan JS, Levine BJ. Reproductive and hormonal risk factors for ductal carcinoma in situ of the breast. Cancer Epidemiol Biomarkers Prev 2009; 18:1507-14. [PMID: 19423528 PMCID: PMC3754830 DOI: 10.1158/1055-9965.epi-08-0967] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
One-fifth of all newly diagnosed breast cancer cases are ductal carcinoma in situ (DCIS), but little is known about DCIS risk factors. Recent studies suggest that some subtypes of DCIS (high grade or comedo) share histopathologic and epidemiologic characteristics with invasive disease, whereas others (medium or low grade or non-comedo) show different patterns. To investigate whether reproductive and hormonal risk factors differ among comedo and non-comedo types of DCIS and invasive breast cancer (IBC), we used a population-based case-control study of 1,808 invasive and 446 DCIS breast cancer cases and their age and race frequency-matched controls (1,564 invasive and 458 DCIS). Three or more full-term pregnancies showed a strong inverse association with comedo-type DCIS [odds ratio (OR), 0.53; 95% confidence interval (95% CI), 0.30-0.95] and a weaker inverse association for non-comedo DCIS (OR, 0.73; 95% CI, 0.42-1.27). Several risk factors (age at first full-term pregnancy, breast-feeding, and age at menopause) showed similar associations for comedo-type DCIS and IBC but different associations for non-comedo DCIS. Ten or more years of oral contraceptive showed a positive association with comedo-type DCIS (OR, 1.31; 95% CI, 0.70-2.47) and IBC (OR, 2.33; 95% CI, 1.06-5.09) but an inverse association for non-comedo DCIS (OR, 0.51; 95% CI, 0.25-1.04). Our results support the theory that comedo-type DCIS may share hormonal and reproductive risk factors with IBC, whereas the etiology of non-comedo DCIS deserves further investigation.
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Affiliation(s)
- Lynette S Phillips
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106, USA.
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Kuerer HM, Albarracin CT, Yang WT, Cardiff RD, Brewster AM, Symmans WF, Hylton NM, Middleton LP, Krishnamurthy S, Perkins GH, Babiera G, Edgerton ME, Czerniecki BJ, Arun BK, Hortobagyi GN. Ductal Carcinoma in Situ: State of the Science and Roadmap to Advance the Field. J Clin Oncol 2009; 27:279-88. [DOI: 10.1200/jco.2008.18.3103] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Purpose Ductal carcinoma in situ (DCIS) is the fourth leading cancer for women in the United States. Understanding of the biology and clinical behavior of DCIS is imperfect. This article highlights the current knowledge base and the scientific roadmap needed to advance the field. Methods This article is based on work done by and consultations obtained from leading experts in the field over a 6-month period that culminated in a full-day symposium designed to systematically review the most pertinent MEDLINE published reports and develop a roadmap to elucidate the molecular steps of carcinogenesis, reduce the extent or prevent the need for therapies, eliminate recurrences, and reduce morbidity. Results Expression profiling of pure DCIS will help elucidate the molecular characteristics that distinguish high-risk lesions from clinically irrelevant lesions. The development of new methods of extracting RNA from processed tissues may provide opportunities for research. Mammography often underestimates the pathologic extent of DCIS; other imaging methods need to be investigated for detection and monitoring of disease stability or progression. Novel biologic agents are being delivered in neoadjuvant clinical trials, and alternative methods for breast irradiation are being studied. Future trials of treatment versus no treatment for biologically selected cases of DCIS should be developed. Conclusion There is a critical need for a concerted international effort among patients with DCIS, clinicians, and basic scientists to conduct the research necessary to improve fundamental understanding of the biology and clinical behavior of DCIS and prevent development of invasive breast cancer.
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Affiliation(s)
- Henry M. Kuerer
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Constance T. Albarracin
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Wei T. Yang
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Robert D. Cardiff
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Abenaa M. Brewster
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - W. Fraser Symmans
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Nola M. Hylton
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Lavinia P. Middleton
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Savitri Krishnamurthy
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - George H. Perkins
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Gildy Babiera
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Mary E. Edgerton
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Brian J. Czerniecki
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Banu K. Arun
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Gabriel N. Hortobagyi
- From the Departments of Surgical Oncology, Pathology, Diagnostic Radiology, Clinical Cancer Prevention, Radiation Oncology, and Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX; Department of Pathology and Laboratory Medicine, University of California, Davis; Department of Radiology, University of California, San Francisco, CA; and the Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
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Nyante SJ, Gammon MD, Malone KE, Daling JR, Brinton LA. The association between oral contraceptive use and lobular and ductal breast cancer in young women. Int J Cancer 2008; 122:936-41. [PMID: 17957781 DOI: 10.1002/ijc.23163] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent reports indicate that the incidence of lobular breast cancer is increasing at a faster rate than ductal breast cancer, which may be due to the differential effects of exogenous hormones by histology. To address this issue, we examined whether the relationship between oral contraceptive use and incident breast cancer differs between lobular and ductal subtypes in young women. A population-based sample of in situ and invasive breast cancer cases between ages 20 and 44 were recruited from Atlanta, GA; Seattle-Puget Sound, WA and central New Jersey. Controls were sampled from the same areas by random-digit dialing, and were frequency matched to the expected case age distribution. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using polytomous logistic regression. Among the 100 lobular cancers, 1,164 ductal cancers, and 1,501 controls, the odds ratios for oral contraceptive ever use were 1.10 (95% CI = 0.68-1.78) for lobular cancers and 1.21 (95% CI = 1.01-1.45) for ductal cancers, adjusted for study site, age at diagnosis, and pap screening history. Our results suggest that the magnitude of the association between ever use of oral contraceptives and breast cancer in young women does not vary strongly by histologic subtype. These results are similar to previous studies that report little difference in the effect of oral contraceptive use on breast cancer by histology.
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Affiliation(s)
- Sarah J Nyante
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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MacKenzie TA, Titus-Ernstoff L, Vacek PM, Geller B, Weiss JE, Goodrich ME, Carney PA. Breast density in relation to risk of ductal carcinoma in situ of the breast in women undergoing screening mammography. Cancer Causes Control 2007; 18:939-45. [PMID: 17638106 DOI: 10.1007/s10552-007-9035-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Accepted: 06/22/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To examine the association between breast density and risk of breast ductal carcinoma in situ (DCIS). METHODS We assessed breast density in relation to DCIS risk using combined data from statewide mammography registries in NH and VT. The prospective analyses were based on 572 DCIS cases arising in 154,936 women (58,496 premenopausal and 96,440 postmenopausal). Women in the study were followed on average 4.1 years. Breast density was scored by community radiologists using BIRADS categories (fatty, scattered density, heterogeneous density, extreme density). RESULTS In premenopausal women, based on 157 cases, the RR for DCIS risk were 0.29 (95% CI: 0.0.04, 2.24) for fatty breasts, 2.06 (95% CI: 1.39, 3.05) for heterogeneous density, and 2.40 (95% CI: 1.47, 3.91) for extreme density, relative to scattered density. In postmenopausal women, based on 369 cases, the RR for DCIS risk were 0.58 (95% CI: 0.37, 0.93) for fatty breasts, 1.41 (95% CI: 1.12, 1.78) for heterogeneous density, and 1.49 (95% CI: 0.93, 2.37) for extreme density, relative to scattered density. The possible interaction between breast density and menopausal status in relation to DCIS risk was not statistically significant. CONCLUSIONS We observed an association between breast density and DCIS risk. Although the association seemed stronger in premenopausal women, there was no evidence of an interaction involving breast density and menopausal status.
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Affiliation(s)
- Todd A MacKenzie
- Department of Community & Family Medicine, Dartmouth Medical School, Norris Cotton Cancer Center, Hanover, NH, USA
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André G, Tunon-de-Lara C, Macgrogan G, Laharie-Mineur H, Bussieres JE, Valentin F, Barreau B, Dilhuydy MH, Dilhuydy JM, Mauriac L, Debled M, Durand M, Mathoulin S, Avril A. [Bilateral ductal carcinoma in situ of the breast: independent events or bilateral disease?]. ACTA ACUST UNITED AC 2007; 36:260-6. [PMID: 17376610 DOI: 10.1016/j.jgyn.2007.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2006] [Revised: 01/08/2007] [Accepted: 02/06/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVES In a retrospective study of bilateral Ductal Carcinoma In Situ (DCIS), cases were analysed to determine the relationship between the two events. MATERIAL AND METHODS From 1971 to 2001, among 812 patients with DCIS in Bergonie Institute, 78 suffering from bilateral DCIS and only19 were treated entirely in our institute. It was either synchronous DCIS or asynchronous (before 6 months). We realised a comparative study between, clinical and pathological characteristics of each DCIS. RESULTS In case of asynchronous DCIS, contra lateral DCIS occurred after a median 75-months period and until 22 years after the first event. We found at least for one histological subtype an agreement in 53% of cases. In 31% of cases, the grade was the same. For low plus intermediary grade versus high grade, the agreement was 53%. There was a subtype and grade agreement of 32% and a subtype or grade agreement in 63% of cases. CONCLUSION Histological agreement between the two lesions indicated the possible existence of in situ bilateral disease in these women. The local relapse rate was 20% and all of them were invasive. The risk of relapse in controlateral breast is high and patient needs a long follow up even in case of mastectomy.
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Affiliation(s)
- G André
- Service de Chirurgie, Institut Bergonié, 229, Cours de l'Argonne, Bordeaux, France
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Gill JK, Press MF, Patel AV, Bernstein L. Oral contraceptive use and risk of breast carcinoma in situ (United States). Cancer Causes Control 2006; 17:1155-62. [PMID: 17006721 DOI: 10.1007/s10552-006-0056-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Accepted: 06/26/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Our study assesses the impact of oral contraceptive use on breast carcinoma in-situ (BCIS) risk. METHODS We conducted a population based case-control study of incident BCIS among black and white women ages 35-64 years residing in Los Angeles County. Case patients (n = 567) were newly diagnosed with BCIS and control participants (n = 614) were identified by random digit dialing between 1 March 1995 and 31 May 1998. All subjects were required to have had a mammogram in the 2 years before case diagnosis or control recruitment. Data were collected during in-person interviews. Multivariable logistic regression analyses provide estimates of odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS Oral contraceptive use was not associated with risk of BCIS (OR = 1.04, 95% CI (0.76-1.42)). Risk did not increase with longer periods of use. No associations with BCIS risk were observed for oral contraceptive use before first term pregnancy, age at first oral contraceptive use, or for time since last use. Risk was not modified by estrogen dose, age, race, or parity. CONCLUSIONS Our results are consistent with recent results on invasive breast cancer reported for the Women's Contraceptive and Reproductive Experiences Study and show no association between oral contraceptive use and risk of BCIS.
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Affiliation(s)
- Jasmeet K Gill
- Etiology Program, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI, USA
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