Is it safe to omit radiotherapy following wide local excision for ductal carcinoma in situ?
BACKGROUND
Debate regarding the use of radiotherapy (RT) after breast conserving surgery is currently one of the most controversial areas in breast cancer management. In our centre we prefer to avoid RT, which is not without its own risks, as a primary treatment modality in the majority of cases of ductal carcinoma in situ (DCIS) that are amenable to wide local excision.


METHODS
Prospectively entered data were reviewed for all patients (n=100) that underwent breast conserving surgery for DCIS by the senior author over a ten year period. Kaplan-Meier survival curves were calculated for the total sample and for a series of univariate analyses.


RESULTS
The mean follow-up for this sample was 50 months. The overall rate of recurrence was 6%, one-third of which were invasive. The estimated eight year disease free survival was 91.6%.


CONCLUSIONS
In this group of patients outcome has not been affected by radiation therapy, hormone manipulation or chemotherapy. It has therefore enabled us to assess recurrence rates free of any potentially confounding treatment related influences. The results from this study suggest, that in our hands, the recurrence rates for DCIS following wide local excision alone are similar to those reported in series in which radiotherapy was used as adjuvant treatment.
Gilleard
O
O
Breast Cancer Unit, Royal Devon and Exeter Foundation Trust, Exeter, Devon.
Davies
M
M
Dunn
J
J
D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant