Duct carcinoma in situ : predictors of local recurrence and progression in patients treated by surgery alone

Between 1972 and 1982, 60 patients with histologically proven duct carcinoma in situ (DCIS) without evidence of invasive disease were treated by surgery alone. Treatment was not randomised and was total mastectomy (19), subcutaneous mastectomy (6) or local excision (35). Follow-up was by clinical ex...

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Bibliographic Details
Published in:British journal of cancer 1990-06, Vol.61 (6), p.869-872
Main Authors: PRICE, P, SINNETT, H. D, GUSTERSON, B, WALSH, G, A'HERN, R. P, MCKINNA, J. A
Format: Article
Language:English
Subjects:
Biological and medical sciences
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Carcinoma, Intraductal, Noninfiltrating - pathology
Carcinoma, Intraductal, Noninfiltrating - surgery
Female
Follow-Up Studies
Gynecology. Andrology. Obstetrics
Humans
Mammary gland diseases
Mastectomy
Medical sciences
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Prognosis
Tumors
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Summary:Between 1972 and 1982, 60 patients with histologically proven duct carcinoma in situ (DCIS) without evidence of invasive disease were treated by surgery alone. Treatment was not randomised and was total mastectomy (19), subcutaneous mastectomy (6) or local excision (35). Follow-up was by clinical examination and mammography with a median follow-up of 9 years (range 4-16 years). Twenty-six patients (43%) have recurred locally. The estimated proportion recurrence free at 7 years is 59% (95% CI 46-72%). Local recurrence on the chest wall occurred in one patient having total mastectomy and in the chest wall or nipple in three patients having subcutaneous mastectomy. Twenty-two patients recurred locally in the breast after conservative surgery. The 7-year recurrence-free rates were 94%, 44% and 45% respectively in the three groups. Of those patients who recurred locally 14/26 (54%) did so with invasive disease. Of the 34 who did not develop local recurrence, two developed metastases. The only factor which correlated with local recurrence and invasive local recurrence on multivariate analysis was conservative surgery (hazard ratio 4.71 (1.59-14.0), P = 0.001, and 4.05 (1.00-18.7), P = 0.03, respectively). DCIS can be an aggressive local disease and local excision may be inadequate treatment.
ISSN:0007-0920
1532-1827
DOI:10.1038/bjc.1990.194