Ductal carcinoma in situ of the breast: Results of treatment by conservative surgery and definitive irradiation

• Published in: International journal of radiation oncology, biology, physics Vol. 28; no. 1; pp. 105 - 111
• Main Authors: Ray, Gordon R., Adelson, Janeth, Hayhurst, Edward, Marzoni, Anthony, Gregg, David, Bronk, Martin, McClenathan, James, Bitar, Nancy, Macio, Ingrid
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 1994; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - surgery; Breast Neoplasms - therapy; Carcinoma in Situ - diagnostic imaging; Carcinoma in Situ - surgery; Carcinoma in Situ - therapy; Carcinoma, Ductal, Breast - diagnostic imaging; Carcinoma, Ductal, Breast - surgery; Carcinoma, Ductal, Breast - therapy; Combined Modality Therapy; Conservative surgery; DCIS; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Intraductal cancer; Irradiation; Mammary gland diseases; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Radiography; Retrospective Studies; Survival Analysis; Tumors; Irradiation; Intraductal cancer; Conservative surgery; DCIS; Cosmetic; Human; Galactophorous duct; Carcinoma; Prognosis; In situ; Malignant tumor; Radiotherapy; Mammary gland diseases; Treatment; Female; Combined treatment; Mammary gland
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/0360-3016(94)90147-3

Purpose : To determine local control, survivorship, and cosmesis in women with ductal carcinoma in situ treated by conservative surgery and radiation therapy. Methods and Materials : We retrospectively analyzed the results of treatment in 56 women with in situ carcinoma of the breast, treated between 1976 and 1990 by conservative surgery and irradiation. Two women had bilateral tumors, for a total of 58 breasts at risk. All patients underwent gross excision of the tumor followed by radiation to the entire breast and a sequential boost to the tumor bed. Eight of the 21 evaluable tumors (38%) had inadequate pathologic margins at the time of excision. Routine reexcision was not performed. The median dose to the whole breast and primary tumor site was 5000 cGy and 6940 cGy, respectively. Median follow-up was 61 months (range 27–191 months). Results : Five patients (9%) failed in the breast for an 8-year actuarial local failure rate of 11%. Median time to failure was 34 months. All five patients with local recurrence underwent mastectomy and are alive, without evidence of disease at a mean of 40 months post mastectomy. The 8-year actuarial absolute and cause specific survivals were 89% and 100%, respectively. Cosmetic results were excellent or totally acceptable in 90% of patients. Conclusion : Patients with ductal carcinoma in situ treated by excision and irradiation achieved acceptable local control and excellent survival and cosmetic results. Because of the long time course associated with local failure, diligent and protracted follow-up is mandatory.