Conservation treatment or mastectomy for DCIS?

0.7 and 0 per cent respectively.

Prof Holmes said: "These results show that nearly all patients with DCIS whose cancer recurs can be treated successfully, whether or not DCIS recurs as new DCIS or invasive cancer. In the small sub-group of patients who develop invasive recurrences, the chances of surviving ten years are better than 90 per cent similar to patients diagnosed with small, node negative cancer.

"The ten-year rate of deaths from all causes and from breast cancer specifically is statistically similar across all three groups. Therefore, regardless of their initial treatment, the three groups of patients had similar rates of survival."

These successes had been gained through careful monitoring of patients after their initial treatment. "At our institution, patients who have been treated for DCIS are screened closely for recurrences, regardless of the treatment they received. For patients treated by lumpectomy alone or lumpectomy plus radiotherapy, follow-up includes mammography of the treated breast twice a year for the first few years, followed by annual mammography. Any abnormality is evaluated with additional imaging and all suspicious finding are biopsied. More recently, we have used breast MRI to evaluate patients for recurrence. As a result of rigorous follow-up, invasive recurrences are more likely to be diagnosed when they are quite small and confined to the breast. When treated at this stage, survival rates are very good," explained Prof Holmes.

The incidence of DCIS is increasing, mainly because of mammography screening programmes, which are able to detect it before it has progressed to a more advanced stage when a woman might be able to feel a lump. Although DCIS is a very early form of breast cancer with an excellent prognosis, often doctors and patients have chosen the more aggressive option of mastectomy, because it carries the least chance of a recurrence. Prof Holmes's findings are significant, sinc

Contact: Emma Mason
Federation of European Cancer Societies

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