Treatment of intraductal carcinoma with limited surgery: long-term follow-up

• Published in: Journal of clinical oncology Vol. 7; no. 3; p. 376
• Main Authors: Gallagher, W J, Koerner, F C, Wood, W C
• Format: Journal Article
• Language: English
• Published: United States 01-03-1989
• Subjects: Adult; Aged; Biopsy; Breast - pathology; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Carcinoma, Intraductal, Noninfiltrating - mortality; Carcinoma, Intraductal, Noninfiltrating - pathology; Carcinoma, Intraductal, Noninfiltrating - surgery; Female; Follow-Up Studies; Humans; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - mortality; Postoperative Care; Retrospective Studies
• ISSN: 0732-183X
• DOI: 10.1200/JCO.1989.7.3.376

Adequate therapy for ductal carcinoma in situ (DCIS) remains controversial. In spite of limited follow-up, recent studies advocate excision and postoperative radiotherapy as treatment. In an effort to provide long-term follow-up information, we evaluated retrospectively a group of 17 patients treated without mastectomy. Thirteen patients were treated with local excision, while four received excision and postoperative radiotherapy. Median follow-up is 100 months, with minimum follow-up 78 months. Five patients (29%) have recurred locally, at a median of 47 months following initial therapy. Three of the local recurrences were invasive carcinomas; two were DCIS. The patients recurring with invasive carcinoma progressed to disseminated disease and death, at a median of 131 months following their local recurrence. Of the eight patients followed for more than 9 years, four (50%) have recurred. Two patients have developed contralateral breast cancer, both treated by mastectomy. No recurrences have occurred in the group receiving radiotherapy. We conclude that long-term follow-up is required to accurately assess local recurrence rates in this disease, and that many recurrences will be invasive carcinomas. Since this lesion is virtually 100% curable by mastectomy, further analysis of long-term studies is warranted before recommending breast conservation to the majority of patients with DCIS.