title: Long-term outcome in patients with ductal carcinoma in situ treated with breast-conserving therapy: implications for optimal follow-up strategies.
abstract: OBJECTIVE
  To determine 20-year rates of local control and outcome-associated factors for ductal carcinoma in situ (DCIS) after breast-conserving therapy (BCT).
  
  
  METHODS
  All DCIS cases receiving BCT between 1980 and 1993 were reviewed. Patient demographics and pathologic factors were analyzed for effect on outcomes, including ipsilateral breast tumor recurrence (IBTR) and survival.
  
  
  RESULTS
  One hundred forty-five cases were evaluated; the median follow-up time was 19.3 years. IBTR developed in 25 patients, for 5-, 10-, 15-, and 20-year actuarial rates of 9.9%, 12.2%, 13.7%, and 17.5%, respectively. One third of IBTRs were elsewhere failures, and 68% of IBTRs occurred <10 years after diagnosis. Young age and cancerization of lobules predicted for IBTR at <10 years, and increased slide involvement and atypical ductal hyperplasia were associated with IBTR at later time points.
  
  
  CONCLUSIONS
  Patients with DCIS treated with BCT have excellent long-term rates of local control. Predictors of IBTR vary over time, and the risk of recurrence seems highest within 10 to 12 years after diagnosis.
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Simona F
authors.initials: SF
authors.lastname: Shaitelman
authors.forename: J Ben
authors.initials: JB
authors.lastname: Wilkinson
authors.forename: Larry L
authors.initials: LL
authors.lastname: Kestin
authors.forename: Hong
authors.initials: H
authors.lastname: Ye
authors.forename: Neal S
authors.initials: NS
authors.lastname: Goldstein
authors.forename: Alvaro A
authors.initials: AA
authors.lastname: Martinez
authors.forename: Frank A
authors.initials: FA
authors.lastname: Vicini
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D011859:Radiography; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D016879:Salvage Therapy / Q000379:methods; D016019:Survival Analysis; D013997:Time Factors; D047368:Tumor Burden