Local and systemic outcomes in DCIS based on tumor and patient characteristics: the radiation oncologist's perspective.
Four randomized clinical trials have shown unanimously the benefit of 50 Gy whole-breast radiotherapy in breast-conserving therapy (BCT) for ductal carcinoma in situ (DCIS). The risk of both DCIS and invasive local recurrence is reduced with about 50%, and this effect is similar for all clinical and histological subgroups analyzed. Younger age and involved margin status are the most important factors for an increased risk of local recurrence. In these subgroups, even with radiotherapy, the observed local recurrence rates are more than 20% at 10 years, which is considerably higher than reported local recurrence rates after BCT for invasive breast cancer. The optimal radiotherapy dose in BCT for DCIS has yet to be established. Also, at present, a subgroup of lesions in which the recurrence rate is so low that radiotherapy can be safely omitted has not yet been identified.
Department of Radiotherapy, Academic Medical Centre, PO Box 22660, 1100 DD Amsterdam, the Netherlands. n.bijker@amc.uva.nl
Nina
N
Bijker
Geertjan
G
van Tienhoven
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000517:prevention & control; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000517:prevention & control; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D016896:Treatment Outcome