title: Invasive local recurrence increased after radiation therapy for ductal carcinoma in situ.
abstract: BACKGROUND
  It is thought that equal numbers of invasive and noninvasive recurrences develop after conservative treatment for ductal carcinoma in situ. We analyzed our data to see if this was true.
  
  
  METHODS
  A prospective database of 878 conservatively treated patients with ductal carcinoma in situ was analyzed.
  
  
  RESULTS
  Among 551 excision patients, there were 88 recurrences. Thirty-five percent were invasive. Among 327 excision plus radiotherapy patients, there were 59 recurrences. Fifty-three percent were invasive. In an attempt to predict which patients develop invasive recurrences, prolonged time to recurrence was the only statistically significant factor.
  
  
  CONCLUSIONS
  The median time to local recurrence for irradiated patients was more than twice as long when compared with nonirradiated patients, during which there is more time for local recurrence to progress to invasion. Irradiated patients had more breast scarring, making diagnosis by palpation and mammography harder. Irradiated patients develop invasive recurrences at a statistically higher rate than nonirradiated patients. Follow-up evaluation with magnetic resonance imaging should be considered.
authors.affiliation: Hoag Breast Care Center, One Hoag Dr., Newport Beach, CA 92663, USA. lisaeguerra@gmail.com
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Guerra
authors.forename: Robina M
authors.initials: RM
authors.lastname: Smith
authors.forename: Anna
authors.initials: A
authors.lastname: Kaminski
authors.forename: Michael D
authors.initials: MD
authors.lastname: Lagios
authors.forename: Melvin J
authors.initials: MJ
authors.lastname: Silverstein
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D044584:Carcinoma, Ductal / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome