ASBrS 2017: Is Adjuvant Whole-Breast Radiation Therapy Necessary for Ductal Carcinoma in Situ?
Research has shown that whole-breast radiation therapy (WBRT) following excision for ductal carcinoma in situ (DCIS) decreases the rate of ipsilateral breast tumor recurrence, but it does not seem to improve overall survival, so it may be safely omitted in some low-risk patients, revealed Nicole Zaremba, MD, of the University of Southern California (USC), and colleagues, at the recent American Society of Breast Surgeons (ASBrS) Annual Meeting in Las Vegas (Abstract 254928).
Using a prospective database, the researchers identified patients with pure DCIS and a score of 4, 5, or 6 (low risk) on the USC/Van Nuys Prognostic Index—an algorithm that aids in predicting local recurrence in conservatively treated patients. A total of 461 patients were divided into 3 groups based on treatment: mastectomy (55 patients), excision plus WBRT (82 patients), and excision alone (324 patients).
No significant difference in overall survival was observed across the three treatment groups. Radiation therapy reduced the ipsilateral breast tumor recurrence rate by approximately 50%, but there was no significant difference in the 10-year probability of ipsilateral breast tumor recurrence, regardless of breast-conserving treatment. Based on these findings, the researchers recommend excision alone for patients with low-risk DCIS.