International comparison of cosmetic outcomes of breast conserving surgery and radiation therapy for women with ductal carcinoma in situ of the breast
Breast conserving surgery (BCS) followed by radiation therapy (RT) is the primary management for many women with early-stage, invasive breast cancer and ductal carcinoma in situ (DCIS) [1 –4]. Most women achieve good to excellent cosmesis after BCS and RT but some experience cosmetic failure, defined as fair or poor cosmetic outcomes [5–17]. However, comparisons of cosmetic outcomes across international jurisdictions using contemporary surgical and RT techniques for DCIS are lack ing.
ConclusionsWith mature follow-up, our rates of local recurrence following breast-conserving therapy for DCIS remain very low (1.5% at 10 years). The incidence of CBC was higher than the LR incidence. Predisposing factors for the development of CBC are worthy of investigation.
CONCLUSIONS: Among the patients with invasive carcinoma or DCIS within less than 1 mm from the resection margin, adjuvant RT with higher dose > 66Gy EQD2 might improve local control. Further prospective studies are warranted to validate the benefit and risk of a high dose boost after BCS in patients with a positive resection margin. PMID: 31265973 [PubMed - as supplied by publisher]
ConclusionOlder women at risk for MDD before DCIS diagnosis were less likely to receive RT after BCS, compared to BCS alone or mastectomy.
(American Society for Radiation Oncology) A subset of patients with low-risk breast cancer is highly unlikely to see cancer return following breast conservation surgery but can lower that risk even further with radiation therapy, finds a new long-term clinical trial report. These 12-year follow-up data from the only prospective, randomized trial to compare recurrence outcomes after treatment for low-risk ductal carcinoma in situ (DCIS) were presented last week at the 60th Annual Meeting of the American Society for Radiation Oncology (ASTRO).
AbstractTreatment for ductal carcinoma in-situ (DCIS) has historically been extrapolated from studies of invasive breast cancer. Accepted local therapy approaches range from small local excisions, with or without radiation, to bilateral mastectomies. Systemic treatment with endocrine therapy is often recommended for hormone positive patients. With improvements in imaging, pathologic review, and treatment techniques in the modern era, combined with new information regarding tumor biology, the management of DCIS is rapidly evolving. A multidisciplinary approach to treatment is now more important than ever, with a shift towar...
CONCLUSIONS: The DS was prognostic for risk and predicted RT benefit for DCIS patients. DS identified a clinically meaningful low risk group, and a group with elevated 10-year risks that received substantial RT benefit over baseline. PMID: 30054280 [PubMed - as supplied by publisher]
Abstract Ductal carcinoma in situ has been stable in incidence for a decade and has an excellent prognosis. Breast conservation therapy is safe and effective for most patients. Adjuvant whole breast radiation therapy is recommended to reduce the risk of local recurrence. Accelerated partial breast irradiation is a promising alternative to decrease toxicity and improve cosmetic results. Adjuvant hormonal therapy can reduce local recurrence, but should be used cautiously. Future directions in management include developing predictive tools for guidance for use of adjuvant therapy and selecting low-risk patients ...
In this study, we sought to evaluate the outcomes for patients diagnosed with DCIS treated using accelerated whole breast RT and concomitant lumpectomy boost following breast conserving surgery.
The appropriate negative margin width for women undergoing breast‐conserving surgery for both ductal carcinoma in situ (DCIS) and invasive carcinoma is controversial. This review examines the available data on the margin status for invasive breast cancer and DCIS, and highlights the similarities and differences in tumor biology and standard treatments that affect the local recurrence (LR) risk and, therefore, the optimal surgical margin. Consensus guidelines support a negative margin, defined as no ink on tumor, for invasive carcinoma treated with breast‐conserving therapy. Because of differences in the growth pattern ...
Authors: Kim K, Kim JH, Kim YB, Suh CO, Shin KH, Kim JH, Kim TH, Jung SY, Choi DH, Park W, Ahn SD, Kim SS, Yea JW, Kang MK, Kim DW, Kim YJ Abstract Purpose: The optimal indications for omitting adjuvant radiation therapy (RT) after breast-conserving surgery are still controversial in ductal carcinoma in situ (DCIS) of the breast. The purpose of this study was to validate the role of postoperative RT in DCIS patients aged ≤50 years and with tumor margin widths of