Conservative treatment of breast ductal carcinoma in situ: results of an Italian multi-institutional retrospective studyReportar como inadecuado

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Radiation Oncology

, 7:177

First Online: 25 October 2012Received: 03 April 2012Accepted: 21 October 2012


BackgroundThe incidence of ductal carcinoma in situ DCIS has increased markedly in recent decades. In the past, mastectomy was the primary treatment for patients with DCIS, but as with invasive cancer, breast-conserving surgery followed by radiation therapy RT has become the standard approach. We present the final results of a multi-institutional retrospective study of an Italian Radiation Oncology Group for the study of conservative treatment of DCIS, characterized by a very long period of accrual, from February 1985 to March 2000, and a median follow-up longer than 11 years.

MethodsA collaborative multi-institutional study was conducted in Italy in 10 Radiation Oncology Departments. A consecutive series of 586 women with DCIS histologically confirmed, treated between February 1985 and March 2000, was retrospectively evaluated. Median age at diagnosis was 55 years range: 29–84; 32 patients were 40 years old or younger. All women underwent conservative surgery followed by whole breast RT. Irradiation was delivered to the entire breast, for a median total dose of 50 Gy; the tumour bed was boosted in 295 cases 50% at a median dose of 10 Gy.

ResultsAfter a median follow-up of 136 months range: 16–292 months, 59-586 patients 10% experienced a local recurrence: invasive in 37 cases, intraductal in 20 and not specified in two. Salvage mastectomy was the treatment of choice in 46 recurrent patients; conservative surgery in 10 and it was unknown in three patients. The incidence of local recurrence was significantly higher in women younger than 40 years 31.3% p= 0.0009. Five patients developed distant metastases. Furthermore 40 patients developed a contralateral breast cancer and 31 a second primary tumour in a different site. The 10-year actuarial overall survival OS was 95.5% and the 10-year actuarial disease-specific survival DSS was 99%.

ConclusionsOur results are consistent with those reported in the literature. In particular it has been defined the importance of young age 40 years or less as a relevant risk factor for local recurrence. This retrospective multi-institutional Italian study confirms the long term efficacy of breast conserving surgery with RT in women with DCIS.

KeywordsDuctal carcinoma in situ DCIS Conservative surgery Whole breast radiation therapy RT Risk factors for local recurrence Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-7-177 contains supplementary material, which is available to authorized users.

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Autor: Cristiana Vidali - Orazio Caffo - Cynthia Aristei - Filippo Bertoni - Alberto Bonetta - Marina Guenzi - Cinzia Iotti - Mari


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