{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:49:25Z","timestamp":1787237365300,"version":"build-2736575974"},"reference-count":26,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"12","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2020,4,20]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Primary endocrine therapy for ductal carcinoma in situ (DCIS) as a potential alternative to surgery has been understudied. This trial explored the feasibility of a short-term course of letrozole and sought to determine whether treatment results in measurable radiographic and biologic changes in estrogen receptor (ER)\u2013positive DCIS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS<\/jats:title>\n                    <jats:p>A phase II single-arm multicenter cooperative-group trial was conducted in postmenopausal patients diagnosed with ER-positive DCIS without invasion. Patients were treated with letrozole 2.5 mg per day for 6 months before surgery. Breast magnetic resonance imaging (MRI) was obtained at baseline, 3 months, and 6 months. The primary end point was change in 6-month MRI enhancement volume compared with baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Overall, 79 patients were enrolled and 70 completed 6 months of letrozole. Of these, 67 patients had MRI data available for each timepoint. Baseline MRI volumes ranged from 0.004 to 26.3 cm\n                      <jats:sup>3<\/jats:sup>\n                      . Median reductions from baseline MRI volume (1.4 cm\n                      <jats:sup>3<\/jats:sup>\n                      ) were 0.6 cm\n                      <jats:sup>3<\/jats:sup>\n                      (61.0%) at 3 months ( P &lt; .001) and 0.8 cm\n                      <jats:sup>3<\/jats:sup>\n                      (71.7%) at 6 months ( P &lt; .001). Consistent reductions were seen in median baseline ER H-score (228; median reduction, 15.0; P = .005), progesterone receptor H-score (15; median reduction, 85.0; P &lt; .001), and Ki67 score (12%; median reduction, 6.3%; P = .007). Of the 59 patients who underwent surgery per study protocol, persistent DCIS remained in 50 patients (85%), invasive cancer was detected in six patients (10%), and no residual DCIS or invasive cancer was seen in nine patients (15%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In a cohort of postmenopausal women with ER-positive DCIS, preoperative letrozole resulted in significant imaging and biomarker changes. These findings support future trials of extended endocrine therapy as primary nonoperative treatment of some DCIS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.19.00510","type":"journal-article","created":{"date-parts":[[2020,3,3]],"date-time":"2020-03-03T16:04:17Z","timestamp":1583251457000},"page":"1284-1292","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":24,"title":["Phase II Single-Arm Study of Preoperative Letrozole for Estrogen Receptor\u2013Positive Postmenopausal Ductal Carcinoma In Situ: CALGB 40903 (Alliance)"],"prefix":"10.1200","volume":"38","author":[{"given":"E. Shelley","family":"Hwang","sequence":"first","affiliation":[{"name":"Duke Cancer Institute, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Hyslop","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute, Duke University, Durham, NC"},{"name":"Alliance Statistics and Data Center, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura H.","family":"Hendrix","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute, Duke University, Durham, NC"},{"name":"Alliance Statistics and Data Center, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Duong","sequence":"additional","affiliation":[{"name":"Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Bedrosian","sequence":"additional","affiliation":[{"name":"MD Anderson, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elissa","family":"Price","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Caudle","sequence":"additional","affiliation":[{"name":"MD Anderson, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Hieken","sequence":"additional","affiliation":[{"name":"Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Guenther","sequence":"additional","affiliation":[{"name":"St Elizabeth Medical Center South, Edgewood, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford A.","family":"Hudis","sequence":"additional","affiliation":[{"name":"ASCO, Alexandria, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Winer","sequence":"additional","affiliation":[{"name":"Dana-Farber\/Partners Cancer Care, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan P.","family":"Lyss","sequence":"additional","affiliation":[{"name":"Missouri Baptist Medical Center, St Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Dickson-Witmer","sequence":"additional","affiliation":[{"name":"Christiana Care Health System, Newark, DE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Hoefer","sequence":"additional","affiliation":[{"name":"Sentara Healthcare, Norfolk, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Ollila","sequence":"additional","affiliation":[{"name":"UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Hardman","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Marks","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute, Duke University, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunn-Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Krings","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Esserman","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nola","family":"Hylton","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1206809"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29199"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21321"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djv263"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-017-4436-9"},{"key":"B6","volume-title":"Use of Endocrine Therapy Following Diagnosis of Ductal Carcinoma In Situ or Early Invasive Breast Cancer: Data Points # 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