10-YEAR RESULTS OF TREATMENT OF DUCTAL CARCINOMA IN-SITU (DCIS) OF THE BREAST WITH CONSERVATIVE SURGERY AND RADIOTHERAPY

The optimal treatment of ductal carcinoma in situ (DCIS) of the breast has not yet been established. The effectiveness of adjuvant postopera tive radiotherapy after conservative surgery is debated. Few data are available in Italy on the combined treatment. A collaborative multi-in stitutional study on this issue in 10 radiation oncology departments o f the north-east of Italy was conducted. One hundred and thirty nine w omen with DCIS of the breast were treated between 1980 and 1990. Age r anged between 28 and 88 years (median 50 years). Surgical procedures w ere: quadrantectomy in 108, lumpectomy in 22 and wide excision in 9 ca ses. The axilla was surgically staged in 97 cases: all the patients we re node-negative. Radiation therapy was delivered with Co-60 units (78 %) or 6 MV linear accelerators (22%) for a median total dose to the en tire breast of 50 Gy (mean 49.48 Gy; range 45-60 Gy). The tumour bed w as boosted in 109 cases (78%) at a dose of 4-30 Gy (median 10 Gy) for a minimum tumour dose of 58 Gy. Median follow-up was 81 months. Thirte en local recurrences were recorded, 7 intraductal and 6 invasive. All recurrent patients had a salvage mastectomy and are alive and fi ee of disease. Actuarial overall, cause-specific and recurrence-free surviv al at 10 years are of 93%, 100% and 86%, respectively. The results of this retrospective multicentric study substantiate the favourable data reported in the Literature and confirm the efficacy of the breast-con serving treatment of DCIS employing conservative surgery and adjuvant radiation therapy. (C) 1997 Elsevier Science Ltd.