title: Surgical excision without whole breast irradiation for complete resection of ductal carcinoma in situ identified using strict, unified criteria.
abstract: BACKGROUND
  The definition of complete resection of ductal carcinoma in situ (DCIS) is difficult to standardize because of the high variety of surgical breast conserving procedures, specimen handling, and pathological examinations. Using strictly controlled criteria in a single institute, the present study aimed to determine the ipsilateral breast cancer rate when radiotherapy is omitted following complete resection of DCIS.
  
  
  METHODS
  We retrospectively examined 363 consecutive DCIS patients who underwent breast-conserving surgery, and of these, 125 (34.4%) had complete resection according to the criteria. We finally included 103 patients who omitted radiotherapy. Ipsilateral and contralateral breast cancer events were assessed.
  
  
  RESULTS
  The median follow-up period was 118 months. The incidences of ipsilateral and contralateral breast cancer and ipsilateral invasive breast cancer at 10 years were 10.8%, 9.1%, and 3.6%, respectively. No patient died of breast cancer.
  
  
  CONCLUSIONS
  If complete resection of DCIS can be ensured, the annual incidence of ipsilateral breast cancer, even without irradiation, can be limited to approximately 1%, which equals the incidence of contralateral breast cancer.
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan. Electronic address: takehiko.sakai@jfcr.or.jp.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Sakai
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Iwase
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Natsuki
authors.initials: N
authors.lastname: Teruya
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Akemi
authors.initials: A
authors.lastname: Kataoka
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Kitagawa
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Nakashima
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Ogiya
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Miyagi
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Iijima
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Hidetomo
authors.initials: H
authors.lastname: Morizono
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast Surgery, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan.
authors.forename: Masujiro
authors.initials: M
authors.lastname: Makita
authors.affiliation: Department of Diagnostic Radiology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Gomi
authors.affiliation: Department of Radiation Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Oguchi
authors.affiliation: Department of Medical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Division of Pathology, Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Horii
authors.affiliation: Division of Pathology, Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Futoshi
authors.initials: F
authors.lastname: Akiyama
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ohno
mesh_terms: D001943:Breast Neoplasms / Q000378:metabolism / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000378:metabolism / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011960:Receptors, Estrogen / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D011960:Receptors, Estrogen
keywords: Breast-conserving surgery; Complete resection; Ductal carcinoma in situ; Ipsilateral breast cancer