In a nutshell
This study examined the safety of treatment by surgery alone for low-risk ductal carcinoma in situ patients.
Some background
Ductal carcinoma in situ is an early stage of breast cancer in which the cancer cells are confined to the milk ducts of the breast. For many years, the standard of care for all patients was surgical removal of the affected ducts followed by radiation therapy. In the last decade, it has become more common for low-risk patients to undergo surgery alone, without radiation. The National Comprehensive Cancer Network, an alliance of cancer centers, updated their guidelines in 2008 to define high-risk ductal carcinoma in situ patients as those with larger tumors that could be felt, cancer cells left in the margins (healthy tissue removed alongside tumor tissue) following surgery, and patient age younger than 50. Radiation therapy is recommended for high-risk patients, while surgery alone is recommended for low-risk patients.
The current study followed low-risk patients undergoing surgery alone, to determine the long-term outcomes of these recommendations.
Methods & findings
205 patients with low-risk ductal carcinoma in situ (those over the age of 50, with a tumor size of 20 mm or smaller, with no cancer cells found in the margins) were followed for an average of 51 months (up to 268 months) post-surgery.
Nine patients experienced a local recurrence during the follow-up period. The probability of a local recurrence within 6 years was 6.6%. The probability of a local recurrence within 12 years was 7.8%. There were no deaths due to breast cancer in 12 years of follow-up.
The bottom line
This study concluded that low-risk ductal carcinoma in situ is safe to treat with surgical removal alone.
Published By :
Annals of Surgical Oncology
Date :
Aug 23, 2013
