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Our goal was to identify the effects of adjuvant radiation therapy, or endocrine\u2009\u00b1\u2009radiation therapy versus breast conservation surgery alone in a large multi-center registry of retrospective DCIS cases (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u20091916) with median follow up of 7.0 (IQR: 8.43) years. We show that patients with DCIS who took less than 2 years of adjuvant endocrine therapy alone have a similar second event rate as breast conservation surgery. However, patients who took more than 2 years of endocrine therapy show a significantly reduced second event rate, similar to those who received either radiation or combined endocrine + radiation therapy, which was independent of age, tumor size, grade, or period of diagnosis. This highlights the importance of endocrine therapy duration for risk reduction.\n                  <\/jats:p>","DOI":"10.1038\/s41523-025-00774-3","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T08:50:13Z","timestamp":1751359813000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Insights from a multi-institutional registry show duration of endocrine treatment for DCIS impacts second events"],"prefix":"10.1038","volume":"11","author":[{"given":"Thomas J.","family":"O\u2019Keefe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1937-0859","authenticated-orcid":false,"given":"Christina","family":"Yau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Iaconetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliza","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Case","family":"Brabham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"McGuire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0837-6515","authenticated-orcid":false,"given":"Ann","family":"Griffin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Wallace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9202-4568","authenticated-orcid":false,"given":"Laura J.","family":"Esserman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Harismendy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4502-0035","authenticated-orcid":false,"given":"Gillian L.","family":"Hirst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"774_CR1","doi-asserted-by":"publisher","first-page":"524","DOI":"10.3322\/caac.21754","volume":"72","author":"AN Giaquinto","year":"2022","unstructured":"Giaquinto, A. 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