Literature DB >> 22975615

Impact of margin status on local recurrence after mastectomy for ductal carcinoma in situ.

Stephanie K Childs1, Yu-Hui Chen, Margaret M Duggan, Mehra Golshan, Stephen Pochebit, Rinaa S Punglia, Julia S Wong, Jennifer R Bellon.   

Abstract

PURPOSE: To examine the rate of local recurrence according to the margin status for patients with pure ductal carcinoma in situ (DCIS) treated by mastectomy. METHODS AND MATERIALS: One hundred forty-five consecutive women who underwent mastectomy with or without radiation therapy for DCIS from 1998 to 2005 were included in this retrospective analysis. Only patients with pure DCIS were eligible; patients with microinvasion were excluded. The primary endpoint was local recurrence, defined as recurrence on the chest wall; regional and distant recurrences were secondary endpoints. Outcomes were analyzed according to margin status (positive, close (≤2 mm), or negative), location of the closest margin (superficial, deep, or both), nuclear grade, necrosis, receptor status, type of mastectomy, and receipt of hormonal therapy.
RESULTS: The primary cohort consisted of 142 patients who did not receive postmastectomy radiation therapy (PMRT). For those patients, the median follow-up time was 7.6 years (range, 0.6-13.0 years). Twenty-one patients (15%) had a positive margin, and 23 patients (16%) had a close (≤2 mm) margin. The deep margin was close in 14 patients and positive in 6 patients. The superficial margin was close in 13 patients and positive in 19 patients. One patient experienced an isolated invasive chest wall recurrence, and 1 patient had simultaneous chest wall, regional nodal, and distant metastases. The crude rates of chest wall recurrence were 2/142 (1.4%) for all patients, 1/21 (4.8%) for those with positive margins, 1/23 (4.3%) for those with close margins, and 0/98 for patients with negative margins. PMRT was given as part of the initial treatment to 3 patients, 1 of whom had an isolated chest wall recurrence.
CONCLUSIONS: Mastectomy for pure DCIS resulted in a low rate of local or distant recurrences. Even with positive or close mastectomy margins, the rates of chest wall recurrences were so low that PMRT is likely not warranted.
Copyright © 2013 Elsevier Inc. All rights reserved.

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Year:  2012        PMID: 22975615     DOI: 10.1016/j.ijrobp.2012.07.2377

Source DB:  PubMed          Journal:  Int J Radiat Oncol Biol Phys        ISSN: 0360-3016            Impact factor:   7.038


  12 in total

1.  Impact of Age on Locoregional and Distant Recurrence After Mastectomy for Ductal Carcinoma In Situ With or Without Microinvasion.

Authors:  Anita Mamtani; Faina Nakhlis; Stephanie Downs-Canner; Emily C Zabor; Monica Morrow; Tari A King; Kimberly J Van Zee
Journal:  Ann Surg Oncol       Date:  2019-08-22       Impact factor: 5.344

Review 2.  Current Therapeutic Approaches to DCIS.

Authors:  Kaleigh Doke; Shirley Butler; Melissa P Mitchell
Journal:  J Mammary Gland Biol Neoplasia       Date:  2018-09-29       Impact factor: 2.673

Review 3.  Ductal Carcinoma In Situ of the Breast: Evaluating the Role of Radiation Therapy in the Management and Attempts to Identify Low-risk Patients.

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

4.  DEGRO practical guidelines: radiotherapy of breast cancer II: radiotherapy of non-invasive neoplasia of the breast.

Authors:  R Souchon; M-L Sautter-Bihl; F Sedlmayer; W Budach; J Dunst; P Feyer; R Fietkau; W Haase; W Harms; F Wenz; R Sauer
Journal:  Strahlenther Onkol       Date:  2014-01       Impact factor: 3.621

5.  Incidence and consequence of close margins in patients with ductal carcinoma-in situ treated with mastectomy: is further therapy warranted?

Authors:  Elizabeth Fitzsullivan; Sara A Lari; Benjamin Smith; Abigail S Caudle; Savitri Krishnamurthy; Anthony Lucci; Elizabeth A Mittendorf; Gildy V Babiera; Dalliah M Black; Jamie L Wagner; Isabelle Bedrosian; Wendy Woodward; Sarah M Gainer; Rosa Hwang; Funda Meric-Bernstam; Kelly K Hunt; Henry M Kuerer
Journal:  Ann Surg Oncol       Date:  2013-08-23       Impact factor: 5.344

6.  One-step prepectoral breast reconstruction with porcine dermal matrix-covered implant: a protective technique improving the outcome in post-mastectomy radiation therapy setting.

Authors:  Susanna Polotto; Maria Luisa Bergamini; Giuseppe Pedrazzi; Maria F Arcuri; Francesca Gussago; Leonardo Cattelani
Journal:  Gland Surg       Date:  2020-04

7.  Close or positive resection margins are not associated with an increased risk of chest wall recurrence in women with DCIS treated by mastectomy: a population-based analysis.

Authors:  Jonathan Klein; Iwa Kong; Lawrence Paszat; Sharon Nofech-Mozes; Wedad Hanna; Deva Thiruchelvam; Steven A Narod; Refik Saskin; Susan J Done; Naomi Miller; Bruce Youngson; Alan Tuck; Sandip Sengupta; Leela Elavathil; Prashant A Jani; Elzbieta Slodkowska; Michel Bonin; Eileen Rakovitch
Journal:  Springerplus       Date:  2015-07-10

8.  A Novel Approach to the Management of Margin-positive DCIS in Nipple-sparing Mastectomy.

Authors:  Hilton Becker; Mary Ellen Billington
Journal:  Plast Reconstr Surg Glob Open       Date:  2014-12-05

Review 9.  Postmastectomy radiation therapy: an overview for the practicing surgeon.

Authors:  Reshma Jagsi
Journal:  ISRN Surg       Date:  2013-09-11

10.  Gasless Robot-Assisted Nipple-Sparing Mastectomy: A Case Report.

Authors:  Hyung Seok Park; Joo Heung Kim; Dong Won Lee; Seung Yong Song; Seho Park; Seung Il Kim; Dae Hyun Ryu; Young Up Cho
Journal:  J Breast Cancer       Date:  2018-09-20       Impact factor: 3.588

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