DCIS: Radiation Considerations

AbstractPurpose of ReviewDuctal carcinoma in situ (DCIS) is commonly treated with radiotherapy as a part of breast-conserving therapy, though increasingly the use of routine radiation treatment is being questioned. The intent of this review is to summarize studies on the role of radiotherapy for DCIS, with an emphasis on more recent trials.Recent FindingsWhile older randomized clinical trials have established a local control benefit for adjuvant radiotherapy following breast-conserving surgery in all patients including those with low-risk DCIS, these and subsequent studies have failed to demonstrate any survival benefit. Given the risks associated with radiotherapy, studies have aspired to demonstrate that subgroups of DCIS patients who derive less benefit from treatment may safely avoid adjuvant radiotherapy. Nomograms based on retrospective analyses have been employed to help identify patients for omission of radiotherapy, and genomic assays as a proxy for tumor biology are being explored as strategies for patient selection. When patients do receive radiotherapy, radiation options such as hypofractionation, inclusion of a radiation boost to the resection cavity, and partial-breast irradiation are considerations to help individualize treatment. Finally, initial treatment for DCIS may have implications for subsequent therapy in the setting of salvage therapy for recurrent breast cancer.SummaryMore recent studies on DCIS have aimed at identifying subgroups of DCIS patients who...

Source: Current Breast Cancer Reports - February 17, 2020 Category: Cancer & Oncology Source Type: research