{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T21:58:44Z","timestamp":1757541524326,"version":"3.41.2"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T00:00:00Z","timestamp":1658793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ductal carcinoma in situ (DCIS) is an established precursor to invasive ductal carcinoma (IDC) and its coexistence with IDC appear to favor reduced biological aggressiveness. Its prognostic implication and ability to affect clinical outcome has been understudied in Asia. This study aims to explore if concomitant DCIS affects the clinical behavior and outcomes among Asians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>Stages I to III breast cancer patients with histological proven IDC, diagnosed and treated in a single institution from June 1, 2004 to June 30, 2014 were included in this study. Statistical analyses were conducted using <jats:italic>\u03a7<\/jats:italic><jats:sup>2<\/jats:sup> test, independent <jats:italic>t<\/jats:italic> test, multivariate logistic regression and Kaplan\u2013Meier test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>A total of 818 patients were identified, including 224 and 594 patients with isolated IDC (No\u2010DCIS) and IDC with coexisting DCIS (IDC\u2010DCIS) respectively. Patients with IDC\u2010DCIS were found to have smaller tumors (median: 22\u2009mm, <jats:italic>p<\/jats:italic>\u2009\u2264\u2009.01), estrogen receptor positivity (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.001), progesterone receptor positivity (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and associated with better pathological stage (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.001). Patients with No\u2010DCIS were 1.6 times more likely to develop disease progression (95% CI: 1.1\u20132.3, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.027) and subsequently associated with distant recurrences (20.5% vs. 13.6%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.02). The breast cancer specific 5\u00a0year overall survival rate for patients with No\u2010DCIS and those with IDC\u2010DCIS was 90.9% (95% CI: 86.2%\u201394.5%) and 93.7% (95% CI: 91.4%\u201395.5%), respectively (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.202).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The presence of DCIS component in IDC among Asians is associated with favorable tumor biological profile, thereby indicating reduced disease aggressiveness. Our study is the first to report the clinical significance in terms of disease progression and distant recurrences among Asians.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1646","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T06:23:43Z","timestamp":1658903023000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Does concomitant ductal carcinoma in situ affect the clinical outcome in breast cancer patients with invasive ductal carcinoma: An Asian perspective"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6997-1524","authenticated-orcid":false,"given":"Wai Peng","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Breast Surgery, Department of Surgery Changi General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spoorthi Sudhakar","family":"Shetty","sequence":"additional","affiliation":[{"name":"Division of Breast Surgery, Department of Surgery Changi General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin Mui Jaime","family":"Seah","sequence":"additional","affiliation":[{"name":"Division of Breast Surgery, Department of Surgery Changi General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei Ting","family":"Tan","sequence":"additional","affiliation":[{"name":"Clinical Trials and Research Unit Changi General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su Ming","family":"Tan","sequence":"additional","affiliation":[{"name":"Division of Breast Surgery, Department of Surgery Changi General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra031301"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.pathol.4.110807.092306"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20242"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-879X2002000800008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2014.01.015"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12282-011-0330-1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605655"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.06.039"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rx.2016.02.004"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-019-02930-2"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2016.0037"},{"issue":"2","key":"e_1_2_8_13_1","first-page":"305","article-title":"Evidence 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