Multidisciplinary management of ductal carcinoma in situ: a 10-year experience.
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.
West
John G
JG
Department of Surgery, Breast Care Center at the Cordelia Knott Center for Wellness, 230 S Main St, Orange, CA 92868, USA. jwest@breastcare.com
Qureshi
Azhar
A
Liao
Shu-Yuan
SY
Sutherland
M Linda
ML
Chen
June W
JW
Chacon
Monique
M
Fanning
Caitlin
C
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