title: High nuclear grade and negative estrogen receptor are significant risk factors for recurrence in DCIS.
abstract: BACKGROUND
  Recommendations for adjuvant treatment of DCIS after breast conservation are controversial. We tried to identify further risk factors in a retrospective study of our own practice.
  
  
  METHODS
  Three hundred and thirty-two patients treated by breast conservation between 1978 and 2001 at the Department of General Surgery, University of Vienna were analysed. Tumour size, nuclear grade, hormone receptors, p53, her-2/neu, multifocality, microinvasion and post-operative therapy (irradiation, tamoxifen or combination) were analysed for their influence on breast recurrence.
  
  
  RESULTS
  Overall recurrence rate was 6.1% (8/132). For patients with DCIS showing high nuclear grade or negative estrogen receptor the risk for development of ipsilateral breast recurrence is significantly higher. Newer factors like p53 and her-2/neu do not have any prognostic significance. No recurrence was observed in patients treated by post-operative irradiation and tamoxifen.
  
  
  CONCLUSIONS
  Nuclear grade remains the most significant factor for breast recurrence after DCIS. Hormone receptor status identifies a subset of patients with more favourable prognosis.
authors.affiliation: Department of General Surgery, University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. sebastian.roka@akh-wien.ac.at
authors.forename: S
authors.initials: S
authors.lastname: Roka
authors.forename: M
authors.initials: M
authors.lastname: Rudas
authors.forename: S
authors.initials: S
authors.lastname: Taucher
authors.forename: P
authors.initials: P
authors.lastname: Dubsky
authors.forename: T
authors.initials: T
authors.lastname: Bachleitner-Hofmann
authors.forename: D
authors.initials: D
authors.lastname: Kandioler
authors.forename: M
authors.initials: M
authors.lastname: Gnant
authors.forename: R
authors.initials: R
authors.lastname: Jakesz
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant / Q000379:methods; D011960:Receptors, Estrogen / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013629:Tamoxifen / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011960:Receptors, Estrogen; D013629:Tamoxifen