BACKGROUND: The incidence of local recurrence (LR) after conventional total mastectomy for ductal carcinoma in situ (DCIS) ranges from 1% to 3%. Skin-sparing mastectomy (SSM) preserves the native skin envelope to facilitate immediate breast reconstruction. Because DCIS is generally not clinically apparent, there is a potential for inadequate excision when SSM is performed. Risk factors for local recurrence after SSM for DCIS are examined. STUDY DESIGN: A retrospective review of 223 consecutive patients with DCIS treated by SSM and immediate reconstruction was performed. Age younger than 50 years, tumor size > 40 mm, high tumor grade, tumor necrosis, surgical margins < 1 mm, type of biopsy (excisional versus core), and SSM type were examined as risk factors for recurrence. RESULTS: Mean followup was 82.3 months (range 4.9 to 123.2 months). Recurrences developed in 11 patients (5.1%), including: local (n = 7; 3.3%), regional (n = 2; 0.9%), and distant (n = 2; 0.9%). All seven local recurrences were detected by physical examination. No patients received adjuvant radiation therapy. Two of 19 patients with surgical margins < 1 mm developed LR (10.5%). Univariate analysis showed high tumor grade (p = .019) to influence LR. CONCLUSIONS: The incidence of local recurrence of DCIS after SSM is similar to conventional total mastectomy. Reexcision of close margins should be performed if possible and adjuvant radiation therapy should be considered.
BACKGROUND: The incidence of local recurrence (LR) after conventional total mastectomy for ductal carcinoma in situ (DCIS) ranges from 1% to 3%. Skin-sparing mastectomy (SSM) preserves the native skin envelope to facilitate immediate breast reconstruction. Because DCIS is generally not clinically apparent, there is a potential for inadequate excision when SSM is performed. Risk factors for local recurrence after SSM for DCIS are examined. STUDY DESIGN: A retrospective review of 223 consecutive patients with DCIS treated by SSM and immediate reconstruction was performed. Age younger than 50 years, tumor size > 40 mm, high tumor grade, tumor necrosis, surgical margins < 1 mm, type of biopsy (excisional versus core), and SSM type were examined as risk factors for recurrence. RESULTS: Mean followup was 82.3 months (range 4.9 to 123.2 months). Recurrences developed in 11 patients (5.1%), including: local (n = 7; 3.3%), regional (n = 2; 0.9%), and distant (n = 2; 0.9%). All seven local recurrences were detected by physical examination. No patients received adjuvant radiation therapy. Two of 19 patients with surgical margins < 1 mm developed LR (10.5%). Univariate analysis showed high tumor grade (p = .019) to influence LR. CONCLUSIONS: The incidence of local recurrence of DCIS after SSM is similar to conventional total mastectomy. Reexcision of close margins should be performed if possible and adjuvant radiation therapy should be considered.
Authors: Min Yi; Steven J Kronowitz; Funda Meric-Bernstam; Barry W Feig; W Fraser Symmans; Anthony Lucci; Merrick I Ross; Gildy V Babiera; Henry M Kuerer; Kelly K Hunt Journal: Cancer Date: 2010-10-13 Impact factor: 6.860
Authors: Chirag Shah; Frank A Vicini; Sameer Berry; Thomas B Julian; John Ben Wilkinson; Simona F Shaitelman; Atif Khan; Steven E Finkelstein; Neal Goldstein Journal: Am J Clin Oncol Date: 2015-10 Impact factor: 2.339
Authors: Maria Jose Cortes-Mateos; David Martin; Sergio Sandoval; Manuel E Ruidiaz; Davorka Messmer; Jessica Wang-Rodriguez; William Trogler; Andrew C Kummel; Sarah L Blair Journal: Ann Surg Oncol Date: 2009-01-10 Impact factor: 5.344
Authors: Dengfeng Cao; Theodore N Tsangaris; Nina Kouprina; Lee Shun-Fune Wu; Charles M Balch; Russell Vang; Pedram Argani Journal: Ann Surg Oncol Date: 2008-02-02 Impact factor: 5.344