title: The effect of age in the outcome and treatment of older women with ductal carcinoma in situ.
abstract: The effect of increasing age on outcomes and type of treatment given to older women with ductal carcinoma in situ (DCIS) was assessed. 646 women ≥60 years old (654 cases) receiving surgery for DCIS at Memorial Sloan-Kettering Cancer Center between 2000 and 2007 (8 bilateral) had wide local excision (WLE; 37%), WLE plus radiotherapy (WLE+RT; 41%), or mastectomy (22%). 45%, 38%, and 16% of patients 60-69 years, 70-79 years, and ≥80 years, respectively, received WLE+RT (P<0.001) and 25%, 20%, and 13%, received mastectomy, respectively (P<0.001). Age (P<0.001), grade (P<0.001), and necrosis (P<0.01) were highly associated with treatment. Four-year local recurrence was 3.6%. Overall local recurrence differed by treatment (mastectomy, 0%; WLE, 5%; WLE+RT, 4%; P<0.00001) but not age. It is possible to identify older women with DCIS in whom the risk of recurrence is acceptably low after WLE alone. WLE alone may be a viable treatment option for select older women with DCIS.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, USA. hoa1234@mskcc.org
authors.forename: Alice
authors.initials: A
authors.lastname: Ho
authors.forename: Anuj
authors.initials: A
authors.lastname: Goenka
authors.forename: Nicole
authors.initials: N
authors.lastname: Ishill
authors.forename: Kimberly
authors.initials: K
authors.lastname: Van Zee
authors.forename: Amanda
authors.initials: A
authors.lastname: McLane
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Gonzales
authors.forename: Lee
authors.initials: L
authors.lastname: Tan
authors.forename: Hiram
authors.initials: H
authors.lastname: Cody
authors.forename: Simon
authors.initials: S
authors.lastname: Powell
authors.forename: Beryl
authors.initials: B
authors.lastname: McCormick
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D021701:Sentinel Lymph Node Biopsy; D016896:Treatment Outcome