J Korean Soc Ther Radiol Oncol.  2004 Mar;22(1):11-16.

Treatment Outcome and Analysis of the Prognostic Factors of Ductal Carcinoma in situ Treated with Breast Conserving Surgery and Radiotherapy

• Kim KJ
• Huh SJ
• Park W
• Yang JH
• Nam SJ
• Kim JH
• Lee SK
• Lee JH
• Kang SS
• Lee JE
• Kang MK
• Park YJ
• Nam HR

Abstract

PURPOSE: To evaluate the survival rate, local failure rate and patterns of failure, and analyze the prognostic factors affecting local relapse of ductal carcinoma in situ treated with breast conserving surgery and radiotherapy
Materials and Methods
From June 1995 to December 2001, 96 patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were retrospectively analyzed. The operations were either local or wide excision in all patients, with an axillary lymph node dissection performed in some patients. Radiation dose to the whole breast was 50.4 Gy, over 5 weeks, with 1.8 Gy daily fractions, with additional doses (10~14 Gy) administered to the primary tumor bed in some patients with close (< or =2 mm) or positive resection margin. The median follow-up period was 43 months (range 12~102 months).
RESULTS
The 5-year local relapse free survival and overall survival rates were 91 and 100% respectively. Local relapse occurred in 6 patients (6.3%). Of the 6 recurrences, one was invasive ductal cell carcinoma. With the exception of one, all patients recurred 2 years after surgery. There was no regional recurrence or distant metastasis. Five patients with local recurrence were salvaged with total mastectomy, and are alive with no evidence of disease. One patient with recurrent invasive ductal cell carcinoma will receive salvage treatment. On analysis of the prognostic factors affecting local relapse, none of the factors among the age, status of resection margin, comedo type and nuclear grade affected local relapse. Operation extent also did not affect local control (p=0.30). In the patients with close resection margin, boost irradiation to the primary tumor bed did not affect local control (p=1.0).
CONCLUSIONS
The survival rate and local control of the patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were excellent. Close resection margin and boost irradiation to the primary tumor bed did not affect local relapse, but further follow-up with much more patients is needed.

Keyword

Ductal carcinoma in situ; Breast conserving surgery; Radiotherapy

MeSH Terms

Breast*
Carcinoma, Ductal*
Carcinoma, Intraductal, Noninfiltrating*
Follow-Up Studies
Humans
Lymph Node Excision
Mastectomy, Segmental*
Mastectomy, Simple
Neoplasm Metastasis
Radiotherapy*
Recurrence
Retrospective Studies
Survival Rate
Treatment Outcome*