In a nutshell
This analysis examined long-term outcomes for patients with ductal carcinoma in situ (DCIS) who received different treatments. The authors concluded that in those undergoing breast conserving surgery, cancer recurrence was significantly lower when two (rather than one) additional therapies were given.
Some background
Ductal carcinoma in situ (DCIS) is an early stage of breast cancer in which the cancer cells are confined to the milk ducts of the breast. A possible treatment for DCIS is conservation surgery (CS). This is surgery where only part of the breast tissue is removed. Additional therapies after surgery can include radiation therapy (RT) and tamoxifen (Nolvadex) therapy (TAM). RT uses high-energy radiation to kill cancer cells by damaging their DNA. Tamoxifen is a drug used to treat women with estrogen receptor (ER) positive (dependent on the hormone estrogen for growth) breast cancer. Tamoxifen works by blocking the action of the ER.
Various surgical and additional treatments have been extensively investigated for DCIS, but less is known about long-term outcomes such as recurrence (return of the cancer).
Methods & findings
The current analysis looked at long-term outcomes such as local recurrence for patients with DCIS who received different treatments. 26 studies, with a total of 9391 DCIS patients, were included in the analysis. Information was provided about surgery type, additional therapies received and whether the cancer recurred.
The local recurrence rates were different depending on the combination of treatment received. A treatment involving CT, RT plus TAM had the lowest recurrence rate of 9.7%. Those receiving CS and RT but no TAM had a similar rate of 14.1%. Recurrence rates were significantly higher in those receiving CS and TAM but no RT (24.7%). CS alone had the highest recurrence rate, at 25.1%.
The bottom line
The analysis concluded that for patients with DCIS who undergo breast-conservation surgery, the rate of breast cancer local recurrence was much lower when two additional therapies were given.
The fine print
The data in these studies was collected over approximately 10 years of follow-up, however, an even longer period of follow-up may be necessary to detect differences in recurrence rates.
What’s next?
Discuss the benefits of combination treatments with your doctor.
Published By :
BMC cancer
Date :
Nov 13, 2015
