Flat epithelial atypia and risk of breast cancer: A Mayo cohort study
BACKGROUND Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an “atypical” or high‐risk lesion. Howeve...
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| Veröffentlicht in: | Cancer 2015-05, Vol.121 (10), p.1548-1555 |
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| creator | Said, Samar M. Visscher, Daniel W. Nassar, Aziza Frank, Ryan D. Vierkant, Robert A. Frost, Marlene H. Ghosh, Karthik Radisky, Derek C. Hartmann, Lynn C. Degnim, Amy C. |
| description | BACKGROUND
Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an “atypical” or high‐risk lesion. However, to the authors' knowledge, the long‐term risk of breast cancer in women with FEA is undefined.
METHODS
Specimens with FEA were identified among excisional breast biopsies in the Mayo Clinic Benign Breast Disease Cohort, which includes 11,591 women who had benign biopsy findings at the Mayo Clinic in Rochester, Minnesota between 1967 and 2001. Breast cancer risk among subsets of patients with FEA and nonproliferative, proliferative, and atypical hyperplasia (AH) was assessed using standardized incidence ratios (SIRs) compared with the Iowa Surveillance, Epidemiology, and End Results registry.
RESULTS
FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as having proliferative disease without atypia (PDWA). With median follow‐up of 16.8 years, the SIR for breast cancer in patients with AH plus FEA was 4.74 (95% confidence interval [95% CI], 3.17‐6.81) versus 4.23 (95% CI, 3.44‐5.13) for those with AH without FEA (P = .59). The SIR for patients with PDWA plus FEA was 2.04 (95% CI, 1.23‐3.19) versus 1.90 (95% CI, 1.72‐2.09) for patients with PDWA without FEA (P = .76).
CONCLUSIONS
FEA is an uncommon finding in women with benign breast disease. FEA does not appear to convey an independent risk of breast cancer beyond that of the associated PDWA or AH. Cancer 2015;121:1548–1555. © 2015 American Cancer Society.
Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia has been proposed as a precursor lesion on the pathway to the development of breast cancer. However, it appears to be a benign proliferative finding of the breast that does not convey an independent risk of future breast cancer. |
| doi_str_mv | 10.1002/cncr.29243 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4424157</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1773837534</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5233-6e922aea0b5289b388129a1ccb3eaf338f3d47679bc87b160e948738be1760193</originalsourceid><addsrcrecordid>eNqFkU1LHEEQhpugxHXjJT9A-ijCmP6a6W4Pgix-gSYQEvDW1PTWZNvMTq_ds8r8-4yukXgxp6Koh6eqeAn5zNkRZ0x88Z1PR8IKJT-QCWdWF4wrsUUmjDFTlEre7pDdnO_GVotSfiQ7oqykrbSZkLPzFnqKq9AvsA3QUuiHVQAK3ZymkH_T2NA6IeSeeug8pmN6Sm9giNTHRUw9zf16Pnwi2w20Gfde6pT8PD_7Mbssrr9dXM1OrwtfCimLCq0QgMDqUhhbS2O4sMC9ryVCI6Vp5FzpStvaG13ziqFVRktTI9cV41ZOycnGu1rXS5x77PoErVulsIQ0uAjBvZ10YeF-xQenlFC81KPg4EWQ4v0ac--WIXtsW-gwrrPjelwndSnV_9HKsBEvx8-m5HCD-hRzTti8XsSZe4rIPUXkniMa4f1_f3hF_2YyAnwDPIYWh3dUbvZ19n0j_QO7w5sp</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1680177552</pqid></control><display><type>article</type><title>Flat epithelial atypia and risk of breast cancer: A Mayo cohort study</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><source>Alma/SFX Local Collection</source><creator>Said, Samar M. ; Visscher, Daniel W. ; Nassar, Aziza ; Frank, Ryan D. ; Vierkant, Robert A. ; Frost, Marlene H. ; Ghosh, Karthik ; Radisky, Derek C. ; Hartmann, Lynn C. ; Degnim, Amy C.</creator><creatorcontrib>Said, Samar M. ; Visscher, Daniel W. ; Nassar, Aziza ; Frank, Ryan D. ; Vierkant, Robert A. ; Frost, Marlene H. ; Ghosh, Karthik ; Radisky, Derek C. ; Hartmann, Lynn C. ; Degnim, Amy C.</creatorcontrib><description>BACKGROUND
Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an “atypical” or high‐risk lesion. However, to the authors' knowledge, the long‐term risk of breast cancer in women with FEA is undefined.
METHODS
Specimens with FEA were identified among excisional breast biopsies in the Mayo Clinic Benign Breast Disease Cohort, which includes 11,591 women who had benign biopsy findings at the Mayo Clinic in Rochester, Minnesota between 1967 and 2001. Breast cancer risk among subsets of patients with FEA and nonproliferative, proliferative, and atypical hyperplasia (AH) was assessed using standardized incidence ratios (SIRs) compared with the Iowa Surveillance, Epidemiology, and End Results registry.
RESULTS
FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as having proliferative disease without atypia (PDWA). With median follow‐up of 16.8 years, the SIR for breast cancer in patients with AH plus FEA was 4.74 (95% confidence interval [95% CI], 3.17‐6.81) versus 4.23 (95% CI, 3.44‐5.13) for those with AH without FEA (P = .59). The SIR for patients with PDWA plus FEA was 2.04 (95% CI, 1.23‐3.19) versus 1.90 (95% CI, 1.72‐2.09) for patients with PDWA without FEA (P = .76).
CONCLUSIONS
FEA is an uncommon finding in women with benign breast disease. FEA does not appear to convey an independent risk of breast cancer beyond that of the associated PDWA or AH. Cancer 2015;121:1548–1555. © 2015 American Cancer Society.
Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia has been proposed as a precursor lesion on the pathway to the development of breast cancer. However, it appears to be a benign proliferative finding of the breast that does not convey an independent risk of future breast cancer.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.29243</identifier><identifier>PMID: 25639678</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Aged ; Aged, 80 and over ; atypia ; Biopsy - methods ; breast cancer ; Breast Neoplasms - diagnosis ; Breast Neoplasms - epidemiology ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Cohort Studies ; columnar cell lesion of breast ; Epithelial Cells - pathology ; Female ; flat epithelial atypia ; Humans ; Hyperplasia - diagnosis ; Hyperplasia - epidemiology ; Incidence ; Iowa - epidemiology ; Middle Aged ; Minnesota - epidemiology ; Odds Ratio ; Precancerous Conditions - diagnosis ; Precancerous Conditions - epidemiology ; Precancerous Conditions - pathology ; Precancerous Conditions - surgery ; proliferative disease without atypia ; Risk Assessment ; Risk Factors ; SEER Program</subject><ispartof>Cancer, 2015-05, Vol.121 (10), p.1548-1555</ispartof><rights>2015 American Cancer Society</rights><rights>2015 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5233-6e922aea0b5289b388129a1ccb3eaf338f3d47679bc87b160e948738be1760193</citedby><cites>FETCH-LOGICAL-c5233-6e922aea0b5289b388129a1ccb3eaf338f3d47679bc87b160e948738be1760193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.29243$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.29243$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,315,781,785,886,1418,1434,27929,27930,45579,45580,46414,46838</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25639678$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Said, Samar M.</creatorcontrib><creatorcontrib>Visscher, Daniel W.</creatorcontrib><creatorcontrib>Nassar, Aziza</creatorcontrib><creatorcontrib>Frank, Ryan D.</creatorcontrib><creatorcontrib>Vierkant, Robert A.</creatorcontrib><creatorcontrib>Frost, Marlene H.</creatorcontrib><creatorcontrib>Ghosh, Karthik</creatorcontrib><creatorcontrib>Radisky, Derek C.</creatorcontrib><creatorcontrib>Hartmann, Lynn C.</creatorcontrib><creatorcontrib>Degnim, Amy C.</creatorcontrib><title>Flat epithelial atypia and risk of breast cancer: A Mayo cohort study</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND
Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an “atypical” or high‐risk lesion. However, to the authors' knowledge, the long‐term risk of breast cancer in women with FEA is undefined.
METHODS
Specimens with FEA were identified among excisional breast biopsies in the Mayo Clinic Benign Breast Disease Cohort, which includes 11,591 women who had benign biopsy findings at the Mayo Clinic in Rochester, Minnesota between 1967 and 2001. Breast cancer risk among subsets of patients with FEA and nonproliferative, proliferative, and atypical hyperplasia (AH) was assessed using standardized incidence ratios (SIRs) compared with the Iowa Surveillance, Epidemiology, and End Results registry.
RESULTS
FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as having proliferative disease without atypia (PDWA). With median follow‐up of 16.8 years, the SIR for breast cancer in patients with AH plus FEA was 4.74 (95% confidence interval [95% CI], 3.17‐6.81) versus 4.23 (95% CI, 3.44‐5.13) for those with AH without FEA (P = .59). The SIR for patients with PDWA plus FEA was 2.04 (95% CI, 1.23‐3.19) versus 1.90 (95% CI, 1.72‐2.09) for patients with PDWA without FEA (P = .76).
CONCLUSIONS
FEA is an uncommon finding in women with benign breast disease. FEA does not appear to convey an independent risk of breast cancer beyond that of the associated PDWA or AH. Cancer 2015;121:1548–1555. © 2015 American Cancer Society.
Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia has been proposed as a precursor lesion on the pathway to the development of breast cancer. However, it appears to be a benign proliferative finding of the breast that does not convey an independent risk of future breast cancer.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>atypia</subject><subject>Biopsy - methods</subject><subject>breast cancer</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Cohort Studies</subject><subject>columnar cell lesion of breast</subject><subject>Epithelial Cells - pathology</subject><subject>Female</subject><subject>flat epithelial atypia</subject><subject>Humans</subject><subject>Hyperplasia - diagnosis</subject><subject>Hyperplasia - epidemiology</subject><subject>Incidence</subject><subject>Iowa - epidemiology</subject><subject>Middle Aged</subject><subject>Minnesota - epidemiology</subject><subject>Odds Ratio</subject><subject>Precancerous Conditions - diagnosis</subject><subject>Precancerous Conditions - epidemiology</subject><subject>Precancerous Conditions - pathology</subject><subject>Precancerous Conditions - surgery</subject><subject>proliferative disease without atypia</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>SEER Program</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1LHEEQhpugxHXjJT9A-ijCmP6a6W4Pgix-gSYQEvDW1PTWZNvMTq_ds8r8-4yukXgxp6Koh6eqeAn5zNkRZ0x88Z1PR8IKJT-QCWdWF4wrsUUmjDFTlEre7pDdnO_GVotSfiQ7oqykrbSZkLPzFnqKq9AvsA3QUuiHVQAK3ZymkH_T2NA6IeSeeug8pmN6Sm9giNTHRUw9zf16Pnwi2w20Gfde6pT8PD_7Mbssrr9dXM1OrwtfCimLCq0QgMDqUhhbS2O4sMC9ryVCI6Vp5FzpStvaG13ziqFVRktTI9cV41ZOycnGu1rXS5x77PoErVulsIQ0uAjBvZ10YeF-xQenlFC81KPg4EWQ4v0ac--WIXtsW-gwrrPjelwndSnV_9HKsBEvx8-m5HCD-hRzTti8XsSZe4rIPUXkniMa4f1_f3hF_2YyAnwDPIYWh3dUbvZ19n0j_QO7w5sp</recordid><startdate>20150515</startdate><enddate>20150515</enddate><creator>Said, Samar M.</creator><creator>Visscher, Daniel W.</creator><creator>Nassar, Aziza</creator><creator>Frank, Ryan D.</creator><creator>Vierkant, Robert A.</creator><creator>Frost, Marlene H.</creator><creator>Ghosh, Karthik</creator><creator>Radisky, Derek C.</creator><creator>Hartmann, Lynn C.</creator><creator>Degnim, Amy C.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T2</scope><scope>7U2</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20150515</creationdate><title>Flat epithelial atypia and risk of breast cancer: A Mayo cohort study</title><author>Said, Samar M. ; Visscher, Daniel W. ; Nassar, Aziza ; Frank, Ryan D. ; Vierkant, Robert A. ; Frost, Marlene H. ; Ghosh, Karthik ; Radisky, Derek C. ; Hartmann, Lynn C. ; Degnim, Amy C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5233-6e922aea0b5289b388129a1ccb3eaf338f3d47679bc87b160e948738be1760193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>atypia</topic><topic>Biopsy - methods</topic><topic>breast cancer</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Cohort Studies</topic><topic>columnar cell lesion of breast</topic><topic>Epithelial Cells - pathology</topic><topic>Female</topic><topic>flat epithelial atypia</topic><topic>Humans</topic><topic>Hyperplasia - diagnosis</topic><topic>Hyperplasia - epidemiology</topic><topic>Incidence</topic><topic>Iowa - epidemiology</topic><topic>Middle Aged</topic><topic>Minnesota - epidemiology</topic><topic>Odds Ratio</topic><topic>Precancerous Conditions - diagnosis</topic><topic>Precancerous Conditions - epidemiology</topic><topic>Precancerous Conditions - pathology</topic><topic>Precancerous Conditions - surgery</topic><topic>proliferative disease without atypia</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>SEER Program</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Said, Samar M.</creatorcontrib><creatorcontrib>Visscher, Daniel W.</creatorcontrib><creatorcontrib>Nassar, Aziza</creatorcontrib><creatorcontrib>Frank, Ryan D.</creatorcontrib><creatorcontrib>Vierkant, Robert A.</creatorcontrib><creatorcontrib>Frost, Marlene H.</creatorcontrib><creatorcontrib>Ghosh, Karthik</creatorcontrib><creatorcontrib>Radisky, Derek C.</creatorcontrib><creatorcontrib>Hartmann, Lynn C.</creatorcontrib><creatorcontrib>Degnim, Amy C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Said, Samar M.</au><au>Visscher, Daniel W.</au><au>Nassar, Aziza</au><au>Frank, Ryan D.</au><au>Vierkant, Robert A.</au><au>Frost, Marlene H.</au><au>Ghosh, Karthik</au><au>Radisky, Derek C.</au><au>Hartmann, Lynn C.</au><au>Degnim, Amy C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Flat epithelial atypia and risk of breast cancer: A Mayo cohort study</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2015-05-15</date><risdate>2015</risdate><volume>121</volume><issue>10</issue><spage>1548</spage><epage>1555</epage><pages>1548-1555</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>BACKGROUND
Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia (FEA) has been proposed as a precursor lesion on the pathway to the development of breast cancer. It is often referred to as an “atypical” or high‐risk lesion. However, to the authors' knowledge, the long‐term risk of breast cancer in women with FEA is undefined.
METHODS
Specimens with FEA were identified among excisional breast biopsies in the Mayo Clinic Benign Breast Disease Cohort, which includes 11,591 women who had benign biopsy findings at the Mayo Clinic in Rochester, Minnesota between 1967 and 2001. Breast cancer risk among subsets of patients with FEA and nonproliferative, proliferative, and atypical hyperplasia (AH) was assessed using standardized incidence ratios (SIRs) compared with the Iowa Surveillance, Epidemiology, and End Results registry.
RESULTS
FEA was identified in 282 women (2.4%); 130 had associated AH (46%) and 152 (54%) were classified as having proliferative disease without atypia (PDWA). With median follow‐up of 16.8 years, the SIR for breast cancer in patients with AH plus FEA was 4.74 (95% confidence interval [95% CI], 3.17‐6.81) versus 4.23 (95% CI, 3.44‐5.13) for those with AH without FEA (P = .59). The SIR for patients with PDWA plus FEA was 2.04 (95% CI, 1.23‐3.19) versus 1.90 (95% CI, 1.72‐2.09) for patients with PDWA without FEA (P = .76).
CONCLUSIONS
FEA is an uncommon finding in women with benign breast disease. FEA does not appear to convey an independent risk of breast cancer beyond that of the associated PDWA or AH. Cancer 2015;121:1548–1555. © 2015 American Cancer Society.
Based on its cytologic features, and its co‐occurrence with atypical hyperplasia and breast cancer, flat epithelial atypia has been proposed as a precursor lesion on the pathway to the development of breast cancer. However, it appears to be a benign proliferative finding of the breast that does not convey an independent risk of future breast cancer.</abstract><cop>United States</cop><pmid>25639678</pmid><doi>10.1002/cncr.29243</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over atypia Biopsy - methods breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - epidemiology Breast Neoplasms - pathology Breast Neoplasms - surgery Cohort Studies columnar cell lesion of breast Epithelial Cells - pathology Female flat epithelial atypia Humans Hyperplasia - diagnosis Hyperplasia - epidemiology Incidence Iowa - epidemiology Middle Aged Minnesota - epidemiology Odds Ratio Precancerous Conditions - diagnosis Precancerous Conditions - epidemiology Precancerous Conditions - pathology Precancerous Conditions - surgery proliferative disease without atypia Risk Assessment Risk Factors SEER Program |
| title | Flat epithelial atypia and risk of breast cancer: A Mayo cohort study |
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