Intraductal Carcinoma of the Prostate (IDC-P) in an Irish prostate cancer patient cohort – An aggressive pathology and a strong familial link

Abstract Introduction The prevalence of IDC-P is poorly studied in the Irish population. We investigated the incidence and clinicopathological characteristics of IDC-P in an Irish prostate cancer patient cohort. We also discuss the rationale for genetic counselling and screening in Irish patients with familial risk factors for IDC-P. Methods We investigated patients diagnosed with IDC-P on prostate biopsy from 2012-2016. Primary outcome measurements were incidence, management and clinical outcomes after follow-up in patients with IDC-P. The secondary outcome measurement was to identify a familial link for IDC-P. Results 1143 patients were diagnosed with PCa on needle biopsy, of which 30 (2.3%) had concomitant IDC-P. Mean age and PSA at diagnosis were 68.6 ± 10.5 years (range 53-85) and 9.15 ± 8.65 ng/ml (range 2.1-166) respectively. In total, 17/30 (57%) were diagnosed with concomitant high grade (i.e. ≥Gleason score 8) PCa. Eight patients (27%) were treated with radical prostatectomy; of which 5 had biochemical recurrence (BCR) after 10.55 ± 25.9 months. Eleven patients (37%) received radical radiotherapy; of which 1 had BCR after 36 months. Eleven patients (37%) presented with advanced PCa and were managed with androgen deprivation therapy (ADT) ± chemotherapy. A family history for PCa in first-degree relatives was found in 8 (27%) patients. Conclusion IDC-P is associated with more aggressive clinicopathological features and an increased risk of BCR after treatment. In Ireland, clinical guidelines and a genetic screening pathway are required to provide early detection and appropriate multi-modal management of patients with IDC-P.