Conservation treatment or mastectomy for DCIS?

Hamburg, Germany: Women who have a type of early breast cancer that is confined to the milk ducts have an equally good chance of successful recovery if the cancer recurs, regardless of how they were treated initially, the 4th European Breast Cancer Conference heard today (Friday 19 March).

Professor Dennis Holmes told the meeting in Hamburg that results from his study offered reassuring evidence to women with ductal carcinoma in situ (DCIS) that if they chose to have only the affected area of their breast removed (lumpectomy) rather than the whole breast removed (mastectomy), it would make no difference to their chances of surviving the disease. Even although there was a higher risk of the cancer recurring locally after conservation treatment than after a mastectomy, the women could still be treated successfully and the overall survival rates remained the same.

However, he said that this outcome was dependent on doctors keeping a close eye on the women after their treatment, with regular screenings, so that any recurrence of the breast cancer could be detected early on while it was still small.

Prof Holmes, an assistant professor of clinical surgery at the University of Southern California Keck School of Medicine, said that he and his colleagues had studied data from 1,136 patients who had been treated for DCIS and then followed up for ten years. Professor Melvin J. Silverstein led the team and data from both the Van Nuys Breast Center and USC were included.

Of the 1,136 patients, 286 had had a lumpectomy and radiotherapy, 444 had had a lumpectomy only, and 406 had had a mastectomy.

After ten years, cancer had recurred in the same breast (local recurrence) in 18 per cent (lumpectomy and radiotherapy), 30 per cent (lumpectomy only) and 1.8 per cent (mastectomy) of the women. The rate of distant metastases (recurrences in distant parts of the body) was 2, 1.2 and 1 per cent respectively, while deaths from breast cancer were 2,

Contact: Emma Mason
Federation of European Cancer Societies

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