Responders, n(%) / Non-responders, n(%)
Total no. of patients / 450 (86) / 72 (14)
Age at inclusion, mean (sd) / 59 (10) / 59 (12)
Breast cancer detected by screening (yes) / 270 (60) / 25(35)
Pathological tumor stage
DCIS / 91 (20) / 14 (19)
T1 / 286 (64) / 46 (64)
T2 / 54 (12) / 11 (15)
Tx / 19 (4) / 1 (1)
Invasive tumor grade
Grade I / 117 (26) / 12 (17)
Grade II / 184 (41) / 28 (39)
Grade III / 108 (24) / 22 (31)
Unknown / 41 (9) / 10 (14)
Estrogen receptor status
Negative / 54 (12) / 12 (17)
>10% Positive / 302 (67) / 47 (65)
Unknown / 94 (21) / 13 (18)
HER2 receptor status
Negative / 314 (70) / 52 (72)
Positive / 38 (8) / 6 (8)
Unknown / 98 (22) / 14 (20)
Neo-adjuvant systemic treatment
None / 413 (92) / 61 (85)
Chemotherapy and/or immunotherapy / 32 (7) / 6 (8)
Unknown / 5 (1) / 5 (7)
Surgical treatment
Breast conserving surgery / 440 (98) / 65 (90)
Mastectomy / 9 (2) / 6 (8)
Othera / 1 (0) / 0 (0)
Unknown / 0 (0) / 1 (1)
Axillary procedure
Sentinel node biopsy / 414 (92) / 67 (93)
Axillary lymph node dissection / 5 (1) / 0 (0)
Unknown / 31 (7) / 5 (7)
Adjuvant systemic treatment
None / 266 (59) / 29 (40)
Chemotherapy and/or immunotherapy / 30 (7) / 7 (10)
Chemotherapy and/or hormonal therapy / 46 (10) / 15 (21)
Hormonal treatment / 98 (22) / 16 (22)
Unknown / 10 (2) / 5 (7)
Radiotherapy treatment
Local / 239 (53) / 36 (50)
Local with boost tumorbed / 205 (46) / 29 (40)
Locoregionalb +/- boost tumorbed / 2 (0) / 4 (6)
Unknown / 4 (1) / 3 (4)
NOTE. Categories may not sum to total N because of missing values. Data may not total to 100% because of rounding.
Abbreviations: DCIS, ductal carcinoma in situ; Early-IBC, early invasive breast cancer; SD, standard deviation; HER2, human epidermal growth factor receptor 2.
a Tumor was removed during breast reduction
b Radiotherapy on the breast/chest wall and on the axilla levels I,II or I/II-IV
Supplement Data Table 2. Anxiety and depression scores of DCIS patients compared with early-IBC without (neo)adjuvant systemic treatment .
HADS domain / Group / Baseline / 6 months / 12 months / 18 months / 24 months
N / Meana / 95% CI / MDb / N / Meana / 95% CI / MDb / N / Meana / 95% CI / MDb / N / Meana / 95% CI / MDb / N / Meana / 95% CI / MDb
Anxiety / DCIS / 82 / 5.3 / 4.56-6.04 / -0.4 / 80 / 5.0 / 4.24-5.73 / -0.1 / 68 / 4.7 / 3.95-5.51 / +0.1 / 49 / 4.3 / 3.46-5.17 / -0.6 / 32 / 3.9 / 2.96-4.93 / -0.9
Early-IBC / 146 / 5.7 / 5.15-6.24 / Ref. / 142 / 5.1 / 4.50-5.60 / Ref. / 121 / 4.6 / 4.06-5.21 / Ref. / 83 / 4.9 / 4.26-5.55 / Ref. / 48 / 4.8 / 4.26-5.57 / Ref.
p / 0.40 / 0.89 / 0.85 / 0.28 / 0.19
Depression / DCIS / 81 / 3.4 / 2.62-4.09 / -0.1 / 80 / 3.5 / 2.80-4.28 / +0.3 / 68 / 3.5 / 2.72-4.25 / +0.6 / 49 / 2.8 / 1.94-3.59 / -0.1 / 32 / 2.8 / 1.89-3.76 / 0.0
Early-IBC / 146 / 3.5 / 2.99-4.06 / Ref. / 142 / 3.2 / 2.61-3.69 / Ref. / 121 / 2.9 / 2.37-3.49 / Ref. / 83 / 2.9 / 2.28-3.52 / Ref. / 48 / 2.8 / 2.02-3.49 / Ref.
p / 0.70 / 0.40 / 0.25 / 0.80 / 0.91
Abbreviations: HADS;Hospitalized Anxiety and Depression Scale , DCIS; ductal carcinoma in situ, Early-IBC; early-stage invasive breast cancer
aMean scores adjusted for age. P-values based on Mixed effect models.
bAdjusted mean difference (MD) with patients with early invasive breast cancer (without (neo)adjuvant treatment) as reference category.
Supplement Data Table 3. Results of mixed model analysis of EORTC-QLQ C30. DCIS patients compared with early-IBC with or without systemic treatment.
Functional domain / Group / Baseline / 3 months / 6 months / 12 months / 18 months / 24 months
N / Meana / 95% CI / MDb / N / Meana / 95% CI / MDb / N / Meana / 95% CI / MDb / N / Meana / 95% CI / MDb / N / Meana / 95% CI / MDb / N / Meana / 95% CI / MDb
Global
health / DCIS / 83 / 75.9 / 72.0-79.7 / +0.7 / 87 / 75.7 / 71.9-79.4 / +3.1 / 80 / 76.8 / 72.9-80.6 / +1.9 / 68 / 78.0 / 73.9-82.1 / -1.1 / 48 / 77.2 / 72.5-81.8 / -1.4 / 32 / 82.5 / 77.0-87.9 / +2.3
Early-IBC / 315 / 75.2 / 73.2-77.1 / Ref. / 338 / 72.6 / 70.7-74.5 / Ref. / 317 / 74.9 / 73.0-76.9 / Ref. / 268 / 79.1 / 77.0-81.1 / Ref. / 180 / 78.6 / 76.2-80.9 / Ref. / 117 / 80.2 / 77.4-83.0 / Ref.
p / 0.77 / 0.15 / 0.41 / 0.65 / 0.59 / 0.47
Physical
function / DCIS / 83 / 87.5 / 84.2-90.7 / +1.2 / 87 / 86.2 / 82.9-89.3 / +1.8 / 81 / 86.8 / 83.5-90.0 / +2.1 / 68 / 87.4 / 83.9-90.8 / -0.8 / 49 / 85.0 / 81.2-88.7 / -2.6 / 32 / 87.6 / 832-91.8 / +0.2
Early-IBC / 316 / 86.3 / 84.6-87.9 / Ref. / 341 / 84.4 / 82.7-85.9 / Ref. / 318 / 84.7 / 83.0-86.3 / Ref. / 269 / 88.2 / 86.5-89.9 / Ref. / 181 / 87.6 / 85.7-89.5 / Ref. / 117 / 87.4 / 85.1-89.6 / Ref.
p / 0.52 / 0.33 / 0.27 / 0.69 / 0.23 / 0.95
Role
function / DCIS / 83 / 72.5 / 67.2-77.7 / -1.7 / 87 / 74.5 / 69.3-79.6 / +3.1 / 81 / 77.4 / 72.1-82.7 / +2.4 / 68 / 84.3 / 78.6-89.9 / +2.0 / 49 / 82.1 / 75.7-88.5 / -1.2 / 32 / 84.4 / 76.7-91.9 / -2.4
Early-IBC / 316 / 74.2 / 71.5-76.8 / Ref. / 339 / 71.4 / 68.8-74.0 / Ref. / 318 / 74.9 / 72.2-77.5 / Ref. / 269 / 82.3 / 79.5-85.1 / Ref. / 181 / 83.3 / 80.0-86.5 / Ref. / 117 / 86.8 / 82.8-90.8 / Ref.
p / 0.57 / 0.29 / 0.41 / 0.54 / 0.75 / 0.57
Emotional
function / DCIS / 83 / 79.4 / 75.3-83.5 / +0.6 / 87 / 82.2 / 78.0-86.2 / +2.9 / 81 / 82.1 / 77.8-86.2 / +0.7 / 68 / 84.1 / 79.6-88.4 / -0.7 / 49 / 87.6 / 82.7-92.4 / +4.2 / 32 / 89.3 / 83.5-95.0 / +3.8
Early-IBC / 314 / 78.8 / 76.7-80.9 / Ref. / 338 / 79.3 / 77.2-81.3 / Ref. / 317 / 81.4 / 79.3-83.5 / Ref. / 268 / 84.8 / 82.6-87.0 / Ref. / 180 / 83.4 / 80.8-85.9 / Ref. / 117 / 85.5 / 82.5-88.5 / Ref.
p / 0.79 / 0.21 / 0.79 / 0.77 / 0.14 / 0.25
Social
function / DCIS / 83 / 86.2 / 82.0-90.3 / +3.2 / 87 / 85.9 / 81.8-89.9 / +4.2 / 81 / 88.4 / 84.2-92.5 / +4.0 / 68 / 89.6 / 85.1-94.0 / +1.4 / 49 / 91.4 / 86.3-96.4 / +2.3 / 32 / 91.2 / 85.1-97.2 / -2.0
Early-IBC / 315 / 83.0 / 80.8-85.0 / Ref. / 338 / 81.7 / 79.6-83.7 / Ref. / 317 / 84.4 / 82.3-86.5 / Ref. / 268 / 88.2 / 85.9-90.4 / Ref. / 180 / 89.1 / 86.6-91.7 / Ref. / 117 / 93.2 / 90.0-96.3 / Ref.
p / 0.17 / 0.07 / 0.10 / 0.59 / 0.43 / 0.70
Cognitive
function / DCIS / 83 / 86.1 / 81.7-90.4 / +3.4 / 87 / 84.9 / 80.6-89.1 / +6.5 / 81 / 85.9 / 81.5-90.2 / +5.8 / 68 / 87.5 / 82.8-92.0 / +5.2 / 49 / 88.1 / 83.0-93.2 / +4.9 / 32 / 89.7 / 83.8-95.6 / +4.5
Early-IBC / 314 / 82.7 / 80.4-84.8 / Ref. / 338 / 78.4 / 76.2-80.5 / Ref. / 317 / 80.1 / 77.9-82.2 / Ref. / 268 / 82.3 / 79.9-84.5 / Ref. / 180 / 83.2 / 80.5-85.7 / Ref. / 117 / 85.2 / 82.1-88.2 / Ref.
p / 0.17 / 0.09 / 0.02 / 0.05 / 0.09 / 0.13
Abbreviations: DCIS; ductal carcinoma in situ, Early-IBC; early-stage invasive breast cancer
aMean scores adjusted for age. P-values based on Mixed effect models.
bAdjusted mean difference (MD) with patients with early invasive breast cancer (with or without (neo)adjuvant treatment) as reference category.
Supplement Figure 1. Mean scores and standard errors of the mean on the Hospital Anxiety and Depression Scale (HADS) of patients with ductal carcinoma in situ (n=89)and early invasive breast cancer treated with primary surgery without (neo)adjuvant systemic treatment (n=207) and the Dutch reference population [34] at each time-point.