15-YEAR RESULTS OF BREAST-CONSERVING SURGERY AND DEFINITIVE BREAST IRRADIATION FOR THE TREATMENT OF DUCTAL CARCINOMA IN-SITU OF THE BREAST

Purpose: To determine the 15-year outcome for women with ductal carcin oma in situ (DCIS, intraductal carcinoma) of the breast treated with b reast-conserving surgery followed by definitive breast irradiation. Pa tients and Methods: An analysis was performed of 270 intraductal breas t carcinomas in 268 women from 10 institutions in Europe and the Unite d Stares. In all patients, breast-conserving surgery included complete gross excision of the primary tumor followed by definitive breast irr adiation. When performed, pathologic axillary lymph node staging was n ode-negative (n = 86). The median follow-up time was 10.3 years (range , 0.9 to 26.8). Results: The 15-year actuarial overall survival rate w as 87%, and the 15-year actuarial cause-specific survival rate was 96% . The 15-year actuarial rate of freedom from distant metastases was 96 %. There were 45 local recurrences in the treated breast, and the 15-y ear actuarial rate of local failure was 19%. The median time to local failure was 5.2 years (range, 1.4 to 16.8). A number of clinical and p athologic parameters were evaluated for correlation with local failure , and none were predictive for local failure (all P greater than or eq ual to .15). Conclusion: The results from the present study demonstrat e rates of overall survival, cause-specific survival, and freedom from distant metastases following the treatment of DCIS of the breast usin g breast-conserving surgery and definitive breast irradiation, These r esults support the use of breast-conserving surgery and definitive bre ast irradiation for the treatment of DCIS of the breast.