title: Fifteen-year results of breast-conserving surgery and definitive breast irradiation for the treatment of ductal carcinoma in situ of the breast.
abstract: OBJECTIVE
  To determine the 15-year outcome for women with ductal carcinoma in situ (DCIS, intraductal carcinoma) of the breast treated with breast-conserving surgery followed by definitive breast irradiation.
  
  
  METHODS
  An analysis was performed of 270 intraductal breast carcinomas in 268 women from 10 institutions in Europe and the United States. In all patients, breast-conserving surgery included complete gross excision of the primary tumor followed by definitive breast irradiation. When performed, pathologic axillary lymph node staging was node-negative (n=86). The median follow-up time was 10.3 years (range, 0.9 to 26.8).
  
  
  RESULTS
  The 15-year actuarial overall survival rate was 87%, and the 15-year actuarial cause-specific survival rate was 96%. The 15-year actuarial rate of freedom from distant metastases was 96%. There were 45 local recurrences in the treated breast, and the 15-year actuarial rate of local failure was 19%. The median time to local failure was 5.2 years (range, 1.4 to 16.8). A number of clinical and pathologic parameters were evaluated for correlation with local failure, and none were predictive for local failure (all P > or = .15).
  
  
  CONCLUSIONS
  The results from the present study demonstrate high rates of overall survival, cause-specific survival, and freedom from distant metastases following the treatment of DCIS of the breast using breast-conserving surgery and definitive breast irradiation. These results support the use of breast-conserving surgery and definitive breast irradiation for the treatment of DCIS of the breast.
authors.affiliation: Departments of Radiation Oncology, Pathology, and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: Solin
authors.forename: J
authors.initials: J
authors.lastname: Kurtz
authors.forename: A
authors.initials: A
authors.lastname: Fourquet
authors.forename: R
authors.initials: R
authors.lastname: Amalric
authors.forename: A
authors.initials: A
authors.lastname: Recht
authors.forename: B A
authors.initials: BA
authors.lastname: Bornstein
authors.forename: R
authors.initials: R
authors.lastname: Kuske
authors.forename: M
authors.initials: M
authors.lastname: Taylor
authors.forename: W
authors.initials: W
authors.lastname: Barrett
authors.forename: B
authors.initials: B
authors.lastname: Fowble
authors.forename: B
authors.initials: B
authors.lastname: Haffty
authors.forename: D J
authors.initials: DJ
authors.lastname: Schultz
authors.forename: I T
authors.initials: IT
authors.lastname: Yeh
authors.forename: B
authors.initials: B
authors.lastname: McCormick
authors.forename: M
authors.initials: M
authors.lastname: McNeese
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D002278:Carcinoma in Situ / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D005060:Europe; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016879:Salvage Therapy; D016019:Survival Analysis; D014481:United States