title: Treatment of intraductal carcinoma with limited surgery: long-term follow-up.
abstract: Adequate therapy for ductal carcinoma in situ (DCIS) remains controversial. In spite of limited follow-up, recent studies advocate excision and postoperative radiotherapy as treatment. In an effort to provide long-term follow-up information, we evaluated retrospectively a group of 17 patients treated without mastectomy. Thirteen patients were treated with local excision, while four received excision and postoperative radiotherapy. Median follow-up is 100 months, with minimum follow-up 78 months. Five patients (29%) have recurred locally, at a median of 47 months following initial therapy. Three of the local recurrences were invasive carcinomas; two were DCIS. The patients recurring with invasive carcinoma progressed to disseminated disease and death, at a median of 131 months following their local recurrence. Of the eight patients followed for more than 9 years, four (50%) have recurred. Two patients have developed contralateral breast cancer, both treated by mastectomy. No recurrences have occurred in the group receiving radiotherapy. We conclude that long-term follow-up is required to accurately assess local recurrence rates in this disease, and that many recurrences will be invasive carcinomas. Since this lesion is virtually 100% curable by mastectomy, further analysis of long-term studies is warranted before recommending breast conservation to the majority of patients with DCIS.
authors.affiliation: Department of Surgery, Harvard Medical School, Massachusetts General Hospital Cancer Center, Boston 02114.
authors.forename: W J
authors.initials: WJ
authors.lastname: Gallagher
authors.forename: F C
authors.initials: FC
authors.lastname: Koerner
authors.forename: W C
authors.initials: WC
authors.lastname: Wood
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality; D011182:Postoperative Care; D012189:Retrospective Studies