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Master Thesis

Protocole CINNAMOME : devenir à 5 ans et différences entre CCIS simples et complexes

Abstract : Background: the objective of the Cinnamome prospective multicenter study was to assess the interest of sentinel lymph node biopsy in vacuum-assisted biopsy (VAB)-diagnosed ductal carcinoma in situ (DCIS) of the breast treated by mastectomy. The objective of our study is to evaluate the outcome at 5 years of the Cinnamome population. The secondary objective is to seek to define and to differentiate simple DCIS and complex DCIS. Methods: a descriptive study allowed to analyze the clinical and histological characteristics of our population (pure DCIS, DCIS-MIC and DCIS-IDC), adjuvant treatments received after mastectomy and their state in the date of breaking news. An analytic study consisted in splitting the population into two groups, and identifying differences between « simple DCIS » and « complex DCIS ». Results: an adjuvant treatment was performed in 6.9 % of pure DCIS, 41 % of DCIS-MIC and 85.3 % of DCIS-IDC. The global recurrence rate was 7.3 %, including 6.8 % of pure DCIS, 0 % for DCIS-MIC and 10.3 % of DCIS-IDC. The median period between the initial diagnosis and the recurrence was 50.2 months for pure DCIS and 35 months for DCIS-IDC. In the analytic study, the presence of necrosis on the VAB (p = 0.02), high nuclear grade of the in situ component (p = 0.032) and molecular phenotypes Luminal B or Triple Negative (p = 0,015) were associated with the « complex» type. Conclusions: the risk of recurrence post-mastectomy for extensive DCIS is low. However, the prognosis seems to be clouded when the extensive DCIS is associated with an invasive component. The question arises of the impact of the presence and the extent of an in situ component on the prognosis of the invasive cancer. DCIS are a heterogeneous population which aggressiveness is probably underestimated. Identification of complex DCIS should allow for specific management, in terms of surveillance and possibly adjuvant treatment.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01567782
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Monday, July 24, 2017 - 2:45:41 PM
Last modification on : Thursday, October 26, 2017 - 1:13:02 AM

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Sophie Auriol. Protocole CINNAMOME : devenir à 5 ans et différences entre CCIS simples et complexes. Médecine humaine et pathologie. 2017. ⟨dumas-01567782⟩

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