Factors associated with decision to pursue mastectomy and breast reconstruction for treatment of ductal carcinoma in situ of the breast

• Published in: The American journal of surgery 2013-11, Vol.206 (5), p.682-685
• Main Authors: Sue, Gloria R., M.A, Lannin, Donald R., M.D, Au, Alexander F., M.D, Narayan, Deepak, M.D, Chagpar, Anees B., M.D
• Format: Article
• Language: English
• Subjects: Accreditation; Adult; Age; Age Factors; Aged; Aged, 80 and over; Breast cancer; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breast reconstruction; Cancer therapies; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Carcinoma, Ductal, Breast - pathology; Carcinoma, Ductal, Breast - surgery; Cohort Studies; Decision Making; Ductal carcinoma in situ; Female; Health risk assessment; Histology; Humans; Mammaplasty - methods; Mammography; Mastectomy; Middle Aged; Neoplasm Grading; Radiation therapy; Retrospective Studies; Studies; Surgery; Teaching hospitals; Womens health
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2013.07.001

Abstract Background Factors influencing the treatment of ductal carcinoma in situ with mastectomy and reconstruction are poorly understood. Methods A retrospective cohort study of 196 patients presenting to one institution was performed. Results Forty-seven patients (24.0%) were treated with mastectomy, while 149 (76.0%) underwent breast-conserving surgery. Of the mastectomy patients, 28 (59.6%) elected for reconstruction. On bivariate analysis, patients who opted for mastectomy were younger than those treated with breast-conserving surgery (median age, 51.8 vs 56.5 years; P = .017) and had higher grade tumors (50.0% vs 34.6% grade 3, P = .009). Among patients treated with mastectomy, those who opted for reconstruction were younger than those forgoing reconstruction (49.4 vs 56.9 years, P = .024). Race, ductal carcinoma in situ tumor size, and histologic subtype were not associated with the decision to pursue mastectomy or reconstruction ( P > .05 for all). Conclusions In patients with ductal carcinoma in situ, the decision to pursue mastectomy and reconstruction appears to be driven by younger patient age and higher tumor grade.