Young age is not associated with increased local recurrence for DCIS treated by breast-conserving surgery and radiation.
BACKGROUND
We report local recurrence (LR) after breast-conserving surgery and radiation (BCS + RT) for ductal carcinoma in situ (DCIS) to determine outcomes for patients aged <or=40 years compared with older women.


METHODS
The study included 440 women with DCIS treated from 1978 to 2007. All patients received whole-breast radiotherapy with a boost in 95% of cases. Demographics, characteristics, surgical, and adjuvant treatments were analyzed for an effect on LR.


RESULTS
Median age was 56.5 years with 24 patients aged <or=40. Median DCIS size was 0.8 cm. Re-excision was required in 62% of patients, and in 75% of those aged <or=40. Tamoxifen was used in 22%, but only one patient aged <or=40. Median follow-up was 6.8 years. Actuarial LR was 7% (95% confidence interval of 4-11%) at 10 years and 8% (5-14%) at 15 years. There was no difference in LR by age (P = 0.76).


CONCLUSIONS
The long-term risk of LR after BCS + RT for DCIS is low, even in patients <or=40 years. This may be due to patient selection for small size, high utilization of re-excision, and radiation boost. Young age may be a smaller contributor to LR risk in DCIS than previously suggested.
Turaka
Aruna
A
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
Freedman
Gary M
GM
Li
Tianyu
T
Anderson
Penny R
PR
Swaby
Ramona
R
Nicolaou
Nicos
N
Goldstein
Lori
L
Sigurdson
Elin R
ER
Bleicher
Richard J
RJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000628:therapy*; D002278:Carcinoma in Situ / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*