Relationship of family history and outcome after breast conservation therapy in women with ductal carcinoma in situ of the breast

Purpose: The purpose of this study was to evaluate the relationship between a family history of breast or ovarian cancer and outcome after breast-cons erving surgery and radiation in women presenting with an initial diagnosis of ductal carcinoma in situ (DCIS) of the breast. Methods and Materials: A total of 146 consecutive women with a pathologic d iagnosis of ductal carcinoma irt situ as their first diagnosis of any breas t cancer were identified; 28 (19%) had a positive family history of breast or ovarian cancer in a first-degree relative, 27 (19%) had a positive famil y history in a second-degree relative, and 91 (62%) had no family history. Pathologic, clinical, and treatment factors, and clinical outcomes for each family history group were compared. Cosmesis and complications were record ed at each follow-up. Patients were treated between 1978 and 1995, and the median follow-up was 7.1 years. Results: Patients with a positive family history in a first- or second-degr ee relative each had an 8% incidence of local failure at 10 Sears, while th e negative family history group demonstrated a 16% local failure rate (p = 0.33). Overall survival at 10 Sears for patients with a positive family his tory in a first- or second-degree relative was 100% and for those with a ne gative family history was 91% (p = 0,08). The negative family history group had a higher median age that mag account for the difference in overall sur vival. Cause-specific survival(CSS) was 97%, 100%, and 99%, respectively, a t 10 years (p = 0,25), There were no differences in the cosmetic results or complication rates between women with a positive or negative family histor y. Conclusion: We have shown that a family history of breast and/or ovarian ca ncer is not associated with an adverse outcome for women treated with breas t conservation therapy for DCIS, Local recurrence, cause-specific survival, overall survival, cosmesis, and complication rates were comparable to that of similarly treated women with negative family histories. Therefore, a po sitive family history is not a contraindication for breast conservation the rapy in women with DCIS, (C) 2000 Elsevier Science Inc.