Mj. Silverstein et al., OUTCOME AFTER INVASIVE LOCAL RECURRENCE IN PATIENTS WITH DUCTAL CARCINOMA IN-SITU OF THE BREAST, Journal of clinical oncology, 16(4), 1998, pp. 1367-1373
Purpose: To detail the outcome, in terms of local recurrence, local in
vasive recurrence, distant recurrence, and breast cancer mortality for
patients previously treated for ductal carcinoma in situ (DCIS). Pati
ents and Methods: Clinical, pathologic, and outcome data were collecte
d prospectively for 707 patients with DCIS accrued from 1972 through J
une 1997. Results: There were 74 local recurrences; 39 were noninvasiv
e (DCIS) and 35 were invasive, Fifty-one percent of patients with inva
sive recurrences presented with stage 1 disease; the remainder present
ed with more advanced disease, Invasive local recurrence after mastect
omy was a rare event that occurred in 0.8% of patients. Invasive recur
rence after breast preservation was more common and occurred in 7.4% o
f patients. The 8-year probability of breast cancer mortality after br
east preservation was 2.1%, a number that is likely to increase with l
onger follow-up. The 8-year breast cancer-specific mortality and dista
nt-disease probability for the subgroup of 74 patients with locally re
current disease was 8.8% and 20.8%, respectively, If only the 35 invas
ive recurrences are considered as events, the 8-year breast cancer-spe
cific mortality and distant disease probability was 14.4% and 27.1%, r
espectively. Conclusion: Invasive local recurrence after breast preser
vation treatment for patients with DCIS is a serious event that conver
ts patients with previous stage 0 disease to patients with disease tha
t ranges from stage I to stage IV, These results, however, indicate th
at most DCIS patients with local recurrence can be salvaged. (C) 1998
by American Society of Clinical Oncology.