Radiotherapy after mastectomy for screen-detected ductal carcinoma in situ

TY - JOUR

T1 - Radiotherapy after mastectomy for screen-detected ductal carcinoma in situ

AU - Sloane Project Steering Group

AU - Clements, K

AU - Dodwell, D

AU - Lawrence, G

AU - Ball, G

AU - Francis, A

AU - Pinder, S

AU - Sawyer, E

AU - Wallis, M

AU - Thompson, A M

N1 - Copyright © 2015 Elsevier Ltd. All rights reserved.

PY - 2015/10

Y1 - 2015/10

N2 - BACKGROUND: A role for radiotherapy after mastectomy for ductal carcinoma in situ (DCIS) is unclear. Using a prospective audit of DCIS detected through the NHS Breast Screening Programme we sought to determine a rationale for the use of post mastectomy radiotherapy for DCIS.METHODS: Over a nine year period, from 9972 patients with screen-detected DCIS and complete surgical, pathology, radiotherapy and follow up data, 2944 women underwent mastectomy for DCIS of whom 33 (1.1%) received radiotherapy.RESULTS: Use of post mastectomy radiotherapy was significantly associated with a close (<1 mm) pathology margin (χ(2)(1) 95.81; p < 0.00001), DCIS size (χ(2) (3) 16.96; p < 0.001) and the presence of microinvasion (χ(2)(1) 3.92; p < 0.05). At a median follow up 61 months, no woman who received radiotherapy had an ipsilateral further event, and only 1/33 women (3.0%) had a contralateral event. Of the women known not to have had radiotherapy post mastectomy, 45/2894 (1.6%) had an ipsilateral further event and 83 (2.9%) had a contralateral event.CONCLUSION: Recurrence following mastectomy for DCIS is rare. A close (<1 mm) margin, large tumour size and microinvasion, may merit radiotherapy to reduce ipsilateral recurrence.

AB - BACKGROUND: A role for radiotherapy after mastectomy for ductal carcinoma in situ (DCIS) is unclear. Using a prospective audit of DCIS detected through the NHS Breast Screening Programme we sought to determine a rationale for the use of post mastectomy radiotherapy for DCIS.METHODS: Over a nine year period, from 9972 patients with screen-detected DCIS and complete surgical, pathology, radiotherapy and follow up data, 2944 women underwent mastectomy for DCIS of whom 33 (1.1%) received radiotherapy.RESULTS: Use of post mastectomy radiotherapy was significantly associated with a close (<1 mm) pathology margin (χ(2)(1) 95.81; p < 0.00001), DCIS size (χ(2) (3) 16.96; p < 0.001) and the presence of microinvasion (χ(2)(1) 3.92; p < 0.05). At a median follow up 61 months, no woman who received radiotherapy had an ipsilateral further event, and only 1/33 women (3.0%) had a contralateral event. Of the women known not to have had radiotherapy post mastectomy, 45/2894 (1.6%) had an ipsilateral further event and 83 (2.9%) had a contralateral event.CONCLUSION: Recurrence following mastectomy for DCIS is rare. A close (<1 mm) margin, large tumour size and microinvasion, may merit radiotherapy to reduce ipsilateral recurrence.

KW - Aged

KW - Breast Neoplasms/diagnosis

KW - Carcinoma, Intraductal, Noninfiltrating/diagnosis

KW - Cohort Studies

KW - Disease-Free Survival

KW - Early Detection of Cancer

KW - Female

KW - Humans

KW - Mastectomy

KW - Middle Aged

KW - Neoplasm Recurrence, Local

KW - Neoplasm, Residual

KW - Prospective Studies

KW - Radiotherapy, Adjuvant/methods

U2 - 10.1016/j.ejso.2015.07.021

DO - 10.1016/j.ejso.2015.07.021

M3 - Article

C2 - 26314790

SN - 0748-7983

VL - 41

SP - 1406

EP - 1410

JO - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

JF - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

IS - 10

ER -