Ductal carcinoma in situ detected in the mammographic era: an analysis of clinical, pathologic, and treatment-related factors affecting outcome with breast-conserving therapy.

摘要: Purpose: We reviewed our institution's experience treating predominantly mammographically detected ductal carcinoma in situ (DCIS) with breast-conserving therapy (BCT) to determine if any clinical, pathologic, or treatment-related factors affected outcome. Methods and Materials: From January 2, 1980 6, 1992, 107 breasts 105 patients were treated BCT at William Beaumont Hospital, Royal Oak, MI. All underwent least an excisional biopsy 70 (65%) reexcised. received whole-breast irradiation a median dose of 50.4 Gy (range 43.1 56.0 Gy). Ninety-nine (93%) supplemental boost the tumor bed for total 60.4 59.1 71.8 Gy) using either photons (2 patients), electrons (69 interstitial implant (28 patients). Results: With follow-up 78 months, 10 have failed breast 5- 10-year actuarial local control rate 91.2 89.8%, respectively. Thirteen percent population been followed years more. Three recurrences pure DCIS, seven invasive. salvaged mastectomy. Nine remain without evidence disease 30.6 months after surgery. One patient distantly 36 recurrence ultimate cause specific survival 99%. Potential clinical (age, mammographic findings, method detection, etc.), pathologic (nuclear grade, margins, (dose, technique, reexcision status, etc.) affecting outcome analyzed. No variable was found be associated ipsilateral recurrence. However, when only that occurred within immediately adjacent lumpectomy cavity analyzed, both margin status extent cancerization lobules (COL) near surgical development Conclusions: Patients DCIS achieve excellent rates overall survival. Both COL appear cavity. These data suggest careful attention completeness resection is important determinant