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Table 2 Ipsilateral local recurrence and breast cancer death rates in ductal carcinoma in situ by four main treatment groups (Mastectomy, Breast-Conserving Surgery with or without Radiation Therapy, and Biopsy-only) at ten years - meta-analysis and meta-regression

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

    

Meta-analysisa

Meta-regressionb

        

Unadjusted

Adjusted for weighted mean age & period, & 10-year follow-up

Treatment

Groups

DCIS cases

Local recurrence or death

Rate (%) & 95 % CI

Model

P heterog

I2 heterogc

Rate (%) & 95 % CI

Rate (%) & 95 % CI

Odds ratio

P

All local recurrence

         

Model P-value

      

P < 0.0001

P < 0.0001

P < 0.0001

 

Biopsy

4

117

28

35.8

R

<0.001

83.6

29.8

27.8

14.15

<0.001

    

13.4–58.2

   

15.9–43.8

8.4–47.1

5.26–38.03

 

BCS

11

2605

653

25.2

R

<0.001

86.7

23.9

25.5

12.59

<0.001

    

19.8–30.6

   

18.0–29.9

18.1–32.9

6.28–25.26

 

BCS + RT

13

5746

716

13.0

R

<0.001

78.4

12.7

13.6

5.79

<0.001

    

10.9–15.1

   

9.6–15.8

9.8–17.4

2.90–11.55

 

Mastectomy

8

936

22

3.0

F = R

ns

53.6

2.6

2.6

1.00

 
    

0.9–5.0

   

1.0–4.2

0.8–4.50

-

 

Total

36

9404

1419

        

Linear trend treatment

     

P < 0.001

P < 0.001

P < 0.001

 

Invasive local recurrence

        

Model P-value

      

P < 0.0001

P < 0.0001

P < 0.0001

 

Biopsy

4

117

21

26.6

R

<0.01

77.1

21.0

10.9

6.83

<0.001

    

9.5–43.8

   

10.4–31.7

3.2–18.5

2.91–16.04

 

BCS

11

2601

290

11.0

R

<0.01

64.7

10.6

10.7

6.72

<0.001

    

8.6–13.4

   

7.8–13.4

8.0–13.4

3.83–11.80

 

BCS + RT

10

5499

357

7.4

R

<0.001

80.1

6.7

6.7

4.00

<0.001

    

5.2–9.5

   

5.1–8.4

5.4–8.0

2.26–7.08

 

Mastectomy

8

853

19

2.5

R

<0.05

58.1

2.1

1.8

1.00

 
    

0.49–4.5

   

0.8–3.4

0.8–2.8

  

Total

33

9070

687

        

Linear trend treatment

     

P < 0.001

P < 0.001

P < 0.001

 

Breast cancer deaths

         

Model P-value

      

P = 0.3670

P = 0.1689

P = 0.1689

 

Biopsy

4

117

6

5.2

F = R

ns

18.5

4.9

2.7

2.02

0.262

    

0.3–10.0

   

0.5–9.3

0.0–6.0

0.59–6.91

 

BCS

9

2296

59

2.6

F = R

ns

0

2.3

2.0

1.5

0.256

    

1.9–3.2

   

1.4–3.3

0.9–3.1

0.75–3.02

 

BCS + RT

10

3751

83

2.4

R

<0.001

73.0

2.2

1.9

1.41

0.319

    

1.5–3.4

   

1.5–2.9

1.2–2.6

0.72–2.77

 

Mastectomy

8

936

18

2

R

ns

9.1

1.9

1.3

1.00

 
    

0.9–3.1

   

0.7–3.1

0.3–2.3

-

 

Total

31

7100

166

        

Linear trend treatment

     

P = 0.2281

P = 0.0685

P = 0.0685

 
  1. Abbreviations: DCIS ductal carcinoma in situ, CI confidence interval, BCS breast-conserving surgery, BCS + RT BCS + radiation therapy, F fixed effects, R random effects, ns non-significant. Odds ratio P-comparator is mastectomy
  2. aby variance weighting (Berry)
  3. bby non-linear logistic regression of expanded data to unit records
  4. cI2 assesses heterogeneity of the studies in treatment categories (<30 minimal, 30–75 moderate, >75 considerable)
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BMC Cancer

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