title: Outcome after invasive local recurrence in patients with ductal carcinoma in situ of the breast.
abstract: OBJECTIVE
  To detail the outcome, in terms of local recurrence, local invasive recurrence, distant recurrence, and breast cancer mortality for patients previously treated for ductal carcinoma in situ (DCIS).
  
  
  METHODS
  Clinical, pathologic, and outcome data were collected prospectively for 707 patients with DCIS accrued from 1972 through June 1997.
  
  
  RESULTS
  There were 74 local recurrences; 39 were noninvasive (DCIS) and 35 were invasive. Fifty-one percent of patients with invasive recurrences presented with stage 1 disease; the remainder presented with more advanced disease. Invasive local recurrence after mastectomy was a rare event that occurred in 0.8% of patients. Invasive recurrence after breast preservation was more common and occurred in 7.4% of patients. The 8-year probability of breast cancer mortality after breast preservation was 2.1%, a number that is likely to increase with longer follow-up. The 8-year breast cancer-specific mortality and distant-disease probability for the subgroup of 74 patients with locally recurrent disease was 8.8% and 20.8%, respectively. If only the 35 invasive recurrences are considered as events, the 8-year breast cancer-specific mortality and distant-disease probability was 14.4% and 27.1%, respectively.
  
  
  CONCLUSIONS
  Invasive local recurrence after breast-preservation treatment for patients with DCIS is a serious event that converts patients with previous stage 0 disease to patients with disease that ranges from stage I to stage IV. These results, however, indicate that most DCIS patients with local recurrence can be salvaged.
authors.affiliation: Division of Surgical Oncology, The Breast Center, Western Tumor Medical Group, Van Nuys, CA 91405, USA. melsilver9@aol.com
authors.forename: M J
authors.initials: MJ
authors.lastname: Silverstein
authors.forename: M D
authors.initials: MD
authors.lastname: Lagios
authors.forename: S
authors.initials: S
authors.lastname: Martino
authors.forename: B S
authors.initials: BS
authors.lastname: Lewinsky
authors.forename: P H
authors.initials: PH
authors.lastname: Craig
authors.forename: P J
authors.initials: PJ
authors.lastname: Beron
authors.forename: P
authors.initials: P
authors.lastname: Gamagami
authors.forename: J R
authors.initials: JR
authors.lastname: Waisman
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D002278:Carcinoma in Situ / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D011336:Probability; D016896:Treatment Outcome