Ductal carcinoma in situ and surgery: What type is best?

This study aimed to identify rates of contralateral breast cancer (CBC) and ipsilateral breast tumor recurrence (IBTR) after breast conserving surgery (BCS). This study found that rates of CBC were low and the risk of CBC was not associated with age, family history, presentation, year of surgery or radiation.

Patients with ductal carcinoma in situ of the breast have the option of bilateral mastectomy as treatment. This is the surgical removal of both breast tissues. Breast conserving surgery (BCS) removes only the affected breast. It is unclear if there is a higher risk of cancer recurrence in the ipsilateral breast (same side as original tumor) or contralateral (opposite side) if BCS is used as a treatment option. 

This study aimed to identify rates of contralateral (CBC) and ipsilateral breast tumor recurrence (IBTR) after BCS. Information on 2759 patients was included in the analysis. Patient were followed for an average of 6.8 years. 

151 developed CBC and 344 developed IBTR. IBTR rates were 2.5 higher than CBC. The 10-year rate of CBC was 6.4%. The rate of IBTR at 10 years was 2.5 times higher than the rate of CBC. If radiotherapy was not used after surgery, the IBTR rates were 4 times those of CBC. 

The risk of CBC was not associated with age, family history, presentation, year of surgery or radiation. Hormone treatment was associated with a lower CBC risk.

This study concluded that rates of CBC were low for the groups in this study and the risk of CBC was not associated with age, family history, presentation, year of surgery or radiation.

This was a detailed and well carried out analysis. However, no mention is made of genetic susceptibility such as BRCA which would need to be included as a risk factor. 

Discuss this article with your doctor.