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Table 3 Ipsilateral local recurrence and breast cancer death rates in ductal carcinoma in situ breast conservation cases by adjuvant treatment (Conservation Surgery Alone, Conservation Surgery with Radiation Therapy or Tamoxifen, and Conservation Surgery with both Radiation Therapy and Tamoxifen) 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

OR

P

All local recurrence

         

Model P-value

      

P = 0.0002

P = 0.0003

P = 0.0003

 

CS(alone)

10

2038

541

25.9

R

<0.001

85.5

24.9

25.1

3.12

0.001

    

19.9–32.0

   

19.1–30.6

18.3–31.9

1.62–6.00

 

CS + TAM(no RT)

1

567

112

19.8

R

<0.001

86.7

19.7

24.7

3.05

0.024

    

16.5-23.0

   

7.1–32.3

7.9–41.5

1.16–8.04

 

CS + RT(no TAM)

11

4809

630

14.9

R

<0.001

78.4

13.8

14.1

1.52

0.190

    

11.8-18.0

   

10.6–16.9

10.3–17.8

0.81–2.86

 

CS + RT + TAM

2

937

86

9.2

F = R

ns

53.6

8.5

9.7

1.00

 
    

7.3-11.0

   

3.9–13.2

4.4–15.0

-

 

Total

24

8351

1369

        

Linear trend treatment

     

P < 0.001

P < 0.0001

P < 0.0001

 

Invasive local recurrence

        

Model P-value

      

P = 0.0005

P < 0.0001

P < 0.0001

 

CS(alone)

10

2038

241

11.4

R

<0.05

60.1

11.2

11.3

2.61

0.001

    

8.8–14.1

   

8.8–13.7

8.9–13.8

1.71–3.97

 

CS + TAM(no RT)

1

567

49

8.6

-

-

-

8.6

11.0

2.52

0.001

    

6.7–10.6

   

4.1–13.1

6.2–15.8

1.44–4.41

 

CS + RT(no TAM)

8

4562

317

7.7

R

<0.001

79.0

7.4

7.2

1.59

0.022

    

5.9–9.5

   

5.8–8.9

6.1–8.3

1.07–2.35

 

CS + RT + TAM

2

937

40

4.3

F = R

ns

<0

4.1

4.7

1.00

 
    

3.0–5.6

   

2.2–6.0

3.0–6.4

-

 

Total

21

8104

647

        

Linear trend treatment

     

P < 0.0001

P < 0.0001

P < 0.0001

 

Breast cancer deaths

         

Model P-value

      

P = 0.6160

P = 0.4152

P = 0.4152

 

CS(alone)

8

1729

40

2.3

F = R

ns

<0

2.1

2.1

1.15

0.734

    

1.6-3.0

   

1.1–3.1

0.9–3.2

0.52–2.51

 

CS + TAM(no RT)

1

567

19

3.4

-

-

-

3.3

4.0

2.24

0.128

    

2.1–4.6

   

0.6–5.9

0.2–7.7

0.79–1.27

 

CS + RT(no TAM)

8

2814

67

2.7

R

<0.001

76.4

2.3

2.2

1.21

0.613

    

1.4–3.9

   

1.5–3.2

1.2–3.1

0.58–2.54

 

CS + RT + TAM

2

937

16

1.7

R

ns

<0

1.6

1.8

1.00

 
    

0.9–2.5

   

0.5–2.8

0.6–3.0

-

 

Total

19

6047

142

        

Linear trend treatment

     

P = 0.8591

P = 0.5586

P = 0.5586

 
  1. Abbreviations: DCIS ductal carcinoma in situ, CI confidence interval, CS conserving surgery, CS + RT CS + radiation therapy, TAM tamoxifen, F fixed effects, R random effects, ns non-significant. Odds ratio P-comparator is CS + RT + TAM
  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

ISSN: 1471-2407

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