{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:53:07Z","timestamp":1790639587667,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2017,2,21]],"date-time":"2017-02-21T00:00:00Z","timestamp":1487635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,7,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Women diagnosed with lobular carcinoma in situ (LCIS) have a 3\u2010fold to 10\u2010fold increased risk of developing invasive breast cancer. The objective of this study was to evaluate the life expectancy (LE) and differences in survival offered by active surveillance, risk\u2010reducing chemoprevention, and bilateral prophylactic mastectomy among women with LCIS.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A Markov simulation model was constructed to determine average LE and quality\u2010adjusted LE (QALE) gains for hypothetical cohorts of women diagnosed with LCIS at various ages under alternative risk\u2010reduction strategies. Probabilities for invasive breast cancer, breast cancer\u2010specific mortality, other\u2010cause mortality and the effectiveness of preventive strategies were derived from published studies and from the National Cancer Institute's Surveillance, Epidemiology, and End Results database.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Assuming a breast cancer incidence from 1.02% to 1.37% per year under active surveillance, a woman aged 50 years diagnosed with LCIS would have a total LE of 32.78 years and would gain 0.13 years (1.6 months) in LE by adding chemoprevention and 0.25 years (3.0 months) in LE by adding bilateral prophylactic mastectomy. After quality adjustment, chemoprevention resulted in the greatest QALE for women ages 40 to 60 years at LCIS diagnosis, whereas surveillance remained the preferred strategy for optimizing QALE among women diagnosed at age 65 years and older.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>In this model, among women with a diagnosis of LCIS, breast cancer prevention strategies only modestly affected overall survival, whereas chemoprevention was modeled as the preferred management strategy for optimizing invasive disease\u2010free survival while prolonging QALE form women younger than 65 years. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:2609\u201017<\/jats:bold>. \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30644","type":"journal-article","created":{"date-parts":[[2017,2,21]],"date-time":"2017-02-21T12:42:43Z","timestamp":1487680963000},"page":"2609-2617","source":"Crossref","is-referenced-by-count":10,"title":["Breast cancer prevention strategies in lobular carcinoma in situ: A decision analysis"],"prefix":"10.1002","volume":"123","author":[{"given":"Stephanie M.","family":"Wong","sequence":"first","affiliation":[{"name":"Harvard School of Public Health Boston Massachusetts"},{"name":"Department of Surgery McGill University Health Center Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha K.","family":"Stout","sequence":"additional","affiliation":[{"name":"Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinaa S.","family":"Punglia","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Brigham and Women's Hospital\/Dana\u2010Farber Cancer Institute Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ipshita","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Surgery McGill University Health Center Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuaki","family":"Sagara","sequence":"additional","affiliation":[{"name":"Department of Breast Oncology Sagara Hospital, Hakuaikai Medical Corporation Kagoshima Japan"},{"name":"Department of Surgery Brigham and Women's Hospital\/Dana\u2010Farber Cancer Institute Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehra","family":"Golshan","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital\/Dana\u2010Farber Cancer Institute Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197808)42:2<737::AID-CNCR2820420247>3.0.CO;2-T"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2015.8"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19960901)78:5<1024::AID-CNCR12>3.0.CO;2-4"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.038"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199701000-00008"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0046-8177(91)90105-X"},{"key":"e_1_2_8_8_1","first-page":"57","article-title":"Interpretation of the risk associated with the unexpected finding of lobular carcinoma in situ. 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