Trends in incidence, treatment, survival and subsequent breast cancer in lobular carcinoma in situ in the Netherlands: A population-based analysis
Marissa C. van Maaren,
Agustín Ortega Ávila,
Jeannette G. van Manen,
Marian BE. Menke-Pluijmers,
Jeroen Veltman,
Joost Bart,
Pieter J. Westenend,
Sabine Siesling
Affiliations
Marissa C. van Maaren
Department of Research and Development, Netherlands Comprehensive Cancer Organisation, P.O. Box 19079, 3501, DB, Utrecht, the Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500, AE, Enschede, the Netherlands; Corresponding author. University of Twente, P.O. Box 217, 7500, AE, Enschede, the Netherlands.
Agustín Ortega Ávila
Department of Research and Development, Netherlands Comprehensive Cancer Organisation, P.O. Box 19079, 3501, DB, Utrecht, the Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500, AE, Enschede, the Netherlands
Jeannette G. van Manen
Department of Research and Development, Netherlands Comprehensive Cancer Organisation, P.O. Box 19079, 3501, DB, Utrecht, the Netherlands
Marian BE. Menke-Pluijmers
Department of Surgery, Albert Schweitzer Hospital, P.O. Box 44, 3300, AK, Dordrecht, the Netherlands
Jeroen Veltman
Department of Radiology, Ziekenhuisgroep Twente, P.O. Box 7600, 7600, SZ, Almelo, the Netherlands
Joost Bart
Department of Pathology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700, RB, Groningen, the Netherlands
Pieter J. Westenend
Laboratory of Pathology, Karel Lotsyweg 145, 3318, AL, Dordrecht, the Netherlands
Sabine Siesling
Department of Research and Development, Netherlands Comprehensive Cancer Organisation, P.O. Box 19079, 3501, DB, Utrecht, the Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, P.O. Box 217, 7500, AE, Enschede, the Netherlands
Purpose: We analysed incidence, treatment, survival, occurrence of ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC) after lobular carcinoma in situ (LCIS) in the Netherlands. Methods: All women diagnosed with classic LCIS between 1989 and 2017 were identified from the Netherlands Cancer Registry. We calculated overall (OS), relative survival (RS) and cumulative incidence functions (CIF, accounting for competing risks) of mortality, DCIS and IBC. For IBC, standardised incidence ratios (SIR) of IBC were calculated. Analyses were stratified for surgical treatment. Results: We included 1890 patients. Median age was 51 years. Median follow-up was 8.5 years. In 1989–2017, LCIS incidence increased from 41 to 124, surgical treatment decreased from 100% to 41.1 % – mostly BCS. 10-year OS and 20-year RS exceeded 90 % in all subgroups. Overall, 48 (2.5 %) and 270 (14.3 %) patients were diagnosed with DCIS and IBC. IBCs were mostly early-stage. After mastectomy, 13 of 14 IBCs presented contralaterally. In the other groups, 64.8–70.9 % of IBCs presented ipsilaterally, 34.5–53.9 % of these were lobular. The SIR of ipsilateral IBC was highest after no surgery (6.9, 95%CI:4.9–9.4), lowest after mastectomy (0.2, 95%CI:0.4–0.8). Conclusion: LCIS incidence increased, surgical treatment decreased. The low mortality risks support consideration of active surveillance. However, the increased IBC incidence suggests careful monitoring.
