title: Multidisciplinary management of ductal carcinoma in situ: a 10-year experience.
abstract: BACKGROUND
  Two ductal carcinoma in situ (DCIS) treatment controversies are (1) what is the preferred margin for patients undergoing lumpectomy plus radiation, and (2) is there a subgroup that can be safely treated with lumpectomy alone? A multidisciplinary team was established to evaluate these issues.
  
  
  METHODS
  Patients with DCIS who were candidates for breast-conservation were divided into 2 groups. Group 1 had a minimum 5-mm margin and received radiation, and group 2 had a minimum 10-mm margin and received no radiation.
  
  
  RESULTS
  One hundred fifty-two patients (153 cancers) met the inclusion criteria. The median follow-up was 8.2 years. Overall, there were 6 recurrences (3.92%); 1 of 71 recurred in group 1 (1.40%), and 5 of 82 recurred in group 2 (6.01%).
  
  
  CONCLUSIONS
  Five-millimeter margins plus radiation results in low rates of recurrence. A subgroup of DCIS patients can be identified in which radiation can be safely avoided. The multidisciplinary team approach to managing DCIS enhances the potential for improved outcomes.
authors.affiliation: Department of Surgery, Breast Care Center at the Cordelia Knott Center for Wellness, 230 S Main St, Orange, CA 92868, USA. jwest@breastcare.com
authors.forename: John G
authors.initials: JG
authors.lastname: West
authors.forename: Azhar
authors.initials: A
authors.lastname: Qureshi
authors.forename: Shu-Yuan
authors.initials: SY
authors.lastname: Liao
authors.forename: M Linda
authors.initials: ML
authors.lastname: Sutherland
authors.forename: June W
authors.initials: JW
authors.lastname: Chen
authors.forename: Monique
authors.initials: M
authors.lastname: Chacon
authors.forename: Caitlin
authors.initials: C
authors.lastname: Fanning
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010348:Patient Care Team; D012189:Retrospective Studies