Breast-conservation treatment for patients with ductal carcinoma in situ

Fourteen cases with symptomatic ductal carcinoma in situ (DCIS) were treate d with breast-conservation treatment intensified with endocrine therapy. Ni ne of 14 patients with palpable mass had tumor detected on mammography. CT, ultrasonography, and MRI were able to detect linear and/or spotty lesion o r enhancement suggesting DCIS. Whereas these findings were not particular t o DCIS, the combination of these modalities would be useful in deciding the extent of resection for DCIS. There was no patient selection for breast-co nservation treatment in our department. All patients received tangential an d boost radiation, and were treated with endocrine therapy using anti estro gen drugs. The reason that nine cases had close margins (<5 mm) might be on account of the treatment including lumpectomy with 1 cm of surgical margin . In spite of their margin status, no local or systemic failure was experie nced, and the cosmetic results of most patients were rated as excellent or good. Therefore, our breast-conservation treatment intensified with systemi c therapy is thought to be adequate for patients with symptomatic DCIS. Six of eight cases who received preoperative treatment containing endocrine th erapy with or without CAF chemotherapy showed a decrease in tumor size. Pre operative treatment may effect the microinvasion and/or breast tissue surro unding a DCIS tumor.