Breast-conserving therapy for ductal carcinoma in situ

This retrospective analysis evaluates the treatment results and prognostic factors of 114 patients with ductal carcinoma in situ (DCIS) undergoing bre ast conserving therapy (BCT) at Keio University Hospital Department of Radi ology, between 1988 and 1997. A total of 132 patients with DCIS of the brea st came to our hospital between 1988 and 1997, and 114 cases were suitable candidates for BCT. All of the patients were female and ranged in age from 26 to 81 years (median 46). Ninety-one patients were premenopausal, and 23 were postmenopausal. Median clinical tumor size was 2.0 cm (0-8.0 cm). Post operatively 48 cases received 50 Gy/ 25 fractions of external irradiation t o the whole breast via tangential ports. The follow-up period after treatme nt ranged from Il to 162 months (median 46.7). The local relapse-free rate and overall survival rate of the 114 patients were 89.5% and 100%, respecti vely. Local failure and regional nodal failure occurred in 12 and 1 patient , respectively. Radiotherapy was a significant risk factor for local failur e (p=0.05). No postmenopausal patients developed local failure, but the dif ference did not reach statistical significance (p=0.103). The 12 recurrent cases underwent additional surgery and all remain alive without recurrence, to date, i.e., at least 16 months. Breast-conserving surgery plus irradiat ion is appropriate treatment for DCIS patients.