Armando Orlandi: Cancer Outcomes in Women Without Upfront Surgery for Ductal Carcinoma in Situ
Armando Orlandi, Medical Director at the Agostino Gemelli University Hospital Foundation IRCCS, shared a post on LinkedIn about a paper by Marc D. Ryser et al., published in BMJ.
“Groundbreaking BMJ 2025 Study: DCIS Outcomes Without Immediate Surgery
Key findings from the largest cohort to date (1,780 women):
8-year cumulative incidence of invasive cancer:
- 10.7% overall
- 8.5% in low-risk patients• 13.9% in high-risk patients
- 8-year disease-specific survival: 96.4%
Low-risk criteria:
- Age ≥40 years
- Screen-detected lesion
- Nuclear grade I/II
- Hormone receptor positive
Clinical implications:
- Supports active surveillance for selected DCIS patients
- Reinforces importance of risk stratification tools
- Emphasizes need for shared decision-making
Key takeaway: This study provides crucial real-world evidence to inform patients and clinicians about DCIS natural history, supporting ongoing trials like COMET, LORIS, and LORD.
Context: Only ~2% of US women with DCIS don’t receive immediate surgery – making this data invaluable for clinical practice.
Impact: These outcomes are comparable to high-risk lesions like atypical hyperplasia (6-13% risk), suggesting potential for treatment de-escalation in carefully selected patients.”
Title: Cancer outcomes in women without upfront surgery for ductal carcinoma in situ: observational cohort study
Authors: Marc D. Ryser, Samantha M. Thomas, Yan Li, Thomas Lynch, Anne Barber, Amanda B. Francescatti, Deborah Collyar, Danalyn Byng, Lars J. Grimm, Ann H. Partridge, Alastair M. Thompson, Terry Hyslop, and E. Shelley Hwang
Read The Full Article at BMJ.
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