title: RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation.
abstract: OBJECTIVE
  The Radiation Therapy Oncology Group 9804 study identified good-risk patients with ductal carcinoma in situ (DCIS), a breast cancer diagnosis found frequently in mammographically detected cancers, to test the benefit of radiotherapy (RT) after breast-conserving surgery compared with observation.
  
  
  METHODS
  This prospective randomized trial (1998 to 2006) in women with mammographically detected low- or intermediate-grade DCIS, measuring less than 2.5 cm with margins ≥ 3 mm, compared RT with observation after surgery. The study was designed for 1,790 patients but was closed early because of lower than projected accrual. Six hundred thirty-six patients from the United States and Canada were entered; tamoxifen use (62%) was optional. Ipsilateral local failure (LF) was the primary end point; LF and contralateral failure were estimated using cumulative incidence, and overall and disease-free survival were estimated using the Kaplan-Meier method.
  
  
  RESULTS
  Median follow-up time was 7.17 years (range, 0.01 to 11.33 years). Two LFs occurred in the RT arm, and 19 occurred in the observation arm. At 7 years, the LF rate was 0.9% (95% CI, 0.0% to 2.2%) in the RT arm versus 6.7% (95% CI, 3.2% to 9.6%) in the observation arm (hazard ratio, 0.11; 95% CI, 0.03 to 0.47; P < .001). Grade 1 to 2 acute toxicities occurred in 30% and 76% of patients in the observation and RT arms, respectively; grade 3 or 4 toxicities occurred in 4.0% and 4.2% of patients, respectively. Late RT toxicity was grade 1 in 30%, grade 2 in 4.6%, and grade 3 in 0.7% of patients.
  
  
  CONCLUSIONS
  In this good-risk subset of patients with DCIS, with a median follow-up of 7 years, the LF rate was low with observation but was decreased significantly with the addition of RT. Longer follow-up is planned because the timeline for LF in this setting seems protracted.
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada. mccormib@mskcc.org.
authors.forename: Beryl
authors.initials: B
authors.lastname: McCormick
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Winter
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Clifford
authors.initials: C
authors.lastname: Hudis
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Henry Mark
authors.initials: HM
authors.lastname: Kuerer
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Eileen
authors.initials: E
authors.lastname: Rakovitch
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Smith
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Nour
authors.initials: N
authors.lastname: Sneige
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Moughan
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Amit
authors.initials: A
authors.lastname: Shah
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Germain
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Hartford
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Afshin
authors.initials: A
authors.lastname: Rashtian
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Walker
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Albert
authors.initials: A
authors.lastname: Yuen
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Strom
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Jeannette L
authors.initials: JL
authors.lastname: Wilcox
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Vallow
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Small
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Pu
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kerlin
authors.affiliation: Beryl McCormick and Clifford Hudis, Memorial Sloan-Kettering Cancer Center, New York, NY; Kathryn Winter and Jennifer Moughan, Radiation Therapy Oncology Group Statistical Center, Philadelphia; Amit Shah, York Cancer Center, York; Albert Yuen, Reading Hospital and Medical Center, Reading, PA; Henry Mark Kuerer, Nour Sneige, and Eric A. Strom, The University of Texas MD Anderson Cancer Center, Houston, TX; Barbara L. Smith, Massachusetts General Hospital, Boston, MA; Alan C. Hartford, Dartmouth Hitchcock Medical Center, Lebanon, NH; Afshin Rashtian, University of Southern California, Los Angeles, Los Angeles; Anthony T. Pu, Radiological Associates of Sacramento, Sacramento, CA; Eleanor M. Walker, Henry Ford Hospital, Detroit, MI; Jeannette L. Wilcox, Greenville SC Community Clinical Oncology Program (CCOP), Greenville, SC; Laura A. Vallow, Mayo Clinic, Jacksonville, FL; William Small Jr, Northwestern University Feinberg School of Medicine, Chicago, IL; Kevin Kerlin, Southeast Cancer Control Consortium CCOP, Winston-Salem, NC; Julia White, James Cancer Hospital, Ohio State University, Columbus, OH; Eileen Rakovitch, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario; and Isabelle Germain, L'Hotel-Dieu de Quebec, Quebec, Quebec, Canada.
authors.forename: Julia
authors.initials: J
authors.lastname: White
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000517:prevention & control / Q000532:radiotherapy* / Q000601:surgery; D002170:Canada; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000601:surgery; D019468:Disease Management; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D016017:Odds Ratio; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D016896:Treatment Outcome; D014481:United States; D057832:Watchful Waiting