title: Breast conservative surgery for well-differentiated ductal intraepithelial neoplasia: Risk factors for ipsilateral breast tumor recurrence.
abstract: BACKGROUND
  We retrospectively analyzed 232 patients affected by well differentiated ductal intraepithelial neoplasia (DIN1c or DCIS G1) treated with conservative surgery without adjuvant radiotherapy.
  
  
  RESULTS
  25 invasive and 18 non-invasive local recurrences were observed (median follow-up 80 months; 5-year cumulative incidence: 12.2%). Seven of the 15 young patients (<40 y) developed local recurrence (2 in situ, 5 invasive). Age <50 (HR 1.89, 95% C.I. 1.01-3.45), multifocality (HR 3.21, 95% C.I. 1.46-7.06), Ki-67 > 7% (HR 2.33, 95% C.I. 1.20-4.55) and surgical margins <10 mm (HR 2.00, 95% C.I. 1.06-3.76) were significantly associated with an increased risk of local recurrence.
  
  
  CONCLUSIONS
  Young age, multifocality and small margins appeared as clear risk factors of local recurrence in DIN1c (DCIS G1) population. The presence of multiple poor prognostic features warrant a thorough discussion regarding local treatment.
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Milan, Italy. Electronic address: antonio.toesca@ieo.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Toesca
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy; Department of Occupational Health, University of Milan, Milan, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Botteri
authors.affiliation: Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Lazzeroni
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Jose
authors.initials: J
authors.lastname: Vila
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Manika
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Bettina
authors.initials: B
authors.lastname: Ballardini
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bettarini
authors.affiliation: Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy.
authors.forename: Aliana
authors.initials: A
authors.lastname: Guerrieri-Gonzaga
authors.affiliation: Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Bonanni
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.affiliation: Division of Pathology, European Institute of Oncology, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Veronesi
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.affiliation: Scientific Directorate, European Institute of Oncology, Milan, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Veronesi
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Oreste
authors.initials: O
authors.lastname: Gentilini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D009378:Neoplasms, Multiple Primary / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: Breast cancer; DCIS; DIN; Ductal carcinoma in situ; Radiation therapy