BACKGROUND: After breast conservative treatment (BCT), young age is a predictive factor for recurrence in patients with Ductal Carcinoma In Situ (DCIS) of the breast. The purpose of this study was to evaluate predictive factors for recurrence and outcomes in these younger women (under 40 years) treated for pure DCIS. METHODS: From 1974 to 2003, 207 cases were collected in 12 French Cancer Centers. Median age was 36.3 years and median follow-up 160 months. Seventy four (35.8%) underwent mastectomy, 67 (32.4%) lumpectomy alone and 66 (31.9%) lumpectomy plus radiotherapy. RESULTS: 37 recurrences occurred (17.8%): 14 (38%) were in situ and 23 (62%) invasive. After BCT, the overall rate of recurrence was 27% (33% in the lumpectomy plus radiotherapy group vs. 21% in the lumpectomy alone group). Comedocarcinoma subtype (p = 0.004), histological size more than 10 mm (p = 0.011), necrosis (p = 0.022) and positive margin status (p = 0.019) were statistically significant predictive factors for recurrence. The actuarial 15-year rates of local recurrence were 29%, 42% and 37% in the lumpectomy alone, lumpectomy and whole breast radiotherapy and lumpectomy + whole breast radiotherapy with additional boost groups respectively. After recurrence, the 10-year overall survival rate was 67.2%. CONCLUSION: High recurrence rates (mainly invasive) after BCT in young women with DCIS are confirmed. BCT in this subgroup of patients is possible if clear and large margins are obtained, tumor size is under 11 mm and necrosis- and/or comedocarcinoma-free.
BACKGROUND: After breast conservative treatment (BCT), young age is a predictive factor for recurrence in patients with Ductal Carcinoma In Situ (DCIS) of the breast. The purpose of this study was to evaluate predictive factors for recurrence and outcomes in these younger women (under 40 years) treated for pure DCIS. METHODS: From 1974 to 2003, 207 cases were collected in 12 French Cancer Centers. Median age was 36.3 years and median follow-up 160 months. Seventy four (35.8%) underwent mastectomy, 67 (32.4%) lumpectomy alone and 66 (31.9%) lumpectomy plus radiotherapy. RESULTS: 37 recurrences occurred (17.8%): 14 (38%) were in situ and 23 (62%) invasive. After BCT, the overall rate of recurrence was 27% (33% in the lumpectomy plus radiotherapy group vs. 21% in the lumpectomy alone group). Comedocarcinoma subtype (p = 0.004), histological size more than 10 mm (p = 0.011), necrosis (p = 0.022) and positive margin status (p = 0.019) were statistically significant predictive factors for recurrence. The actuarial 15-year rates of local recurrence were 29%, 42% and 37% in the lumpectomy alone, lumpectomy and whole breast radiotherapy and lumpectomy + whole breast radiotherapy with additional boost groups respectively. After recurrence, the 10-year overall survival rate was 67.2%. CONCLUSION: High recurrence rates (mainly invasive) after BCT in young women with DCIS are confirmed. BCT in this subgroup of patients is possible if clear and large margins are obtained, tumor size is under 11 mm and necrosis- and/or comedocarcinoma-free.
Authors: Rosalinda Alvarado; Sara A Lari; Robert E Roses; Benjamin D Smith; Wei Yang; Elizabeth A Mittendorf; Banu K Arun; Anthony Lucci; Gildy V Babiera; Jamie L Wagner; Abigail S Caudle; Funda Meric-Bernstam; Rosa F Hwang; Isabelle Bedrosian; Kelly K Hunt; Henry M Kuerer Journal: Ann Surg Oncol Date: 2012-05-24 Impact factor: 5.344
Authors: Renée L Mulder; Melissa M Hudson; Smita Bhatia; Wendy Landier; Gill Levitt; Louis S Constine; W Hamish Wallace; Flora E van Leeuwen; Cécile M Ronckers; Tara O Henderson; Chaya S Moskowitz; Danielle N Friedman; Andrea K Ng; Helen C Jenkinson; Charlotte Demoor-Goldschmidt; Roderick Skinner; Leontien C M Kremer; Kevin C Oeffinger Journal: J Clin Oncol Date: 2020-09-29 Impact factor: 44.544
Authors: Renée L Mulder; Leontien C M Kremer; Melissa M Hudson; Smita Bhatia; Wendy Landier; Gill Levitt; Louis S Constine; W Hamish Wallace; Flora E van Leeuwen; Cécile M Ronckers; Tara O Henderson; Mary Dwyer; Roderick Skinner; Kevin C Oeffinger Journal: Lancet Oncol Date: 2013-12 Impact factor: 41.316