Article

Young age is not associated with increased local recurrence for DCIS treated by breast-conserving surgery and radiation.

Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
Journal of Surgical Oncology (impact factor: 2.1). 04/2009; 100(1):25-31. DOI:10.1002/jso.21284 pp.25-31
Source: PubMed

ABSTRACT We report local recurrence (LR) after breast-conserving surgery and radiation (BCS + RT) for ductal carcinoma in situ (DCIS) to determine outcomes for patients aged <or=40 years compared with older women.
The study included 440 women with DCIS treated from 1978 to 2007. All patients received whole-breast radiotherapy with a boost in 95% of cases. Demographics, characteristics, surgical, and adjuvant treatments were analyzed for an effect on LR.
Median age was 56.5 years with 24 patients aged <or=40. Median DCIS size was 0.8 cm. Re-excision was required in 62% of patients, and in 75% of those aged <or=40. Tamoxifen was used in 22%, but only one patient aged <or=40. Median follow-up was 6.8 years. Actuarial LR was 7% (95% confidence interval of 4-11%) at 10 years and 8% (5-14%) at 15 years. There was no difference in LR by age (P = 0.76).
The long-term risk of LR after BCS + RT for DCIS is low, even in patients <or=40 years. This may be due to patient selection for small size, high utilization of re-excision, and radiation boost. Young age may be a smaller contributor to LR risk in DCIS than previously suggested.

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Keywords

24 patients
 
95% confidence interval
 
Actuarial LR
 
adjuvant treatments
 
BCS + RT
 
breast-conserving surgery
 
ductal carcinoma
 
long-term risk
 
Median age
 
Median DCIS size
 
older women
 
one patient
 
patient selection
 
patients
 
re-excision
 
small size
 
smaller contributor
 
Tamoxifen
 
whole-breast radiotherapy
 
Young age