title: Factors associated with decision to pursue mastectomy and breast reconstruction for treatment of ductal carcinoma in situ of the breast.
abstract: BACKGROUND
  Factors influencing the treatment of ductal carcinoma in situ with mastectomy and reconstruction are poorly understood.
  
  
  METHODS
  A retrospective cohort study of 196 patients presenting to one institution was performed.
  
  
  RESULTS
  Forty-seven patients (24.0%) were treated with mastectomy, while 149 (76.0%) underwent breast-conserving surgery. Of the mastectomy patients, 28 (59.6%) elected for reconstruction. On bivariate analysis, patients who opted for mastectomy were younger than those treated with breast-conserving surgery (median age, 51.8 vs. 56.5 years; P = .017) and had higher grade tumors (50.0% vs. 34.6% grade 3, P = .009). Among patients treated with mastectomy, those who opted for reconstruction were younger than those forgoing reconstruction (49.4 vs. 56.9 years, P = .024). Race, ductal carcinoma in situ tumor size, and histologic subtype were not associated with the decision to pursue mastectomy or reconstruction (P > .05 for all).
  
  
  CONCLUSIONS
  In patients with ductal carcinoma in situ, the decision to pursue mastectomy and reconstruction appears to be driven by younger patient age and higher tumor grade.
authors.affiliation: Department of Surgery, Yale University School of Medicine, 20 York Street, 1st Floor, Suite A, New Haven, CT 06510, USA.
authors.forename: Gloria R
authors.initials: GR
authors.lastname: Sue
authors.forename: Donald R
authors.initials: DR
authors.lastname: Lannin
authors.forename: Alexander F
authors.initials: AF
authors.lastname: Au
authors.forename: Deepak
authors.initials: D
authors.lastname: Narayan
authors.forename: Anees B
authors.initials: AB
authors.lastname: Chagpar
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods; D008408:Mastectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D012189:Retrospective Studies
keywords: Breast reconstruction; Ductal carcinoma in situ; Mastectomy