Surgery without radiation inadequate for DCIS, study reveals

BOSTON--A study by researchers at Dana-Farber Cancer Institute and Brigham and Women's Hospital has found that women who chose not to receive radiation therapy following surgery for Ductal Carcinoma In Situ (DCIS) experienced recurrences at a surprisingly high rate. This suggests that surgery alone is inadequate in treating these small, very early breast cancers.

The research, to be presented at the San Antonio Breast Cancer Symposium on Wednesday, Dec. 3, is the first prospective study to evaluate the hypothesis that DCIS (a common type of breast lesion that is harmless as long as it is confined to the milk ducts) can be treated by removing it along with a wide margin of healthy tissue on all sides. If surgery alone proved to be effective, women with DCIS could be spared the inconvenience of daily radiation treatments and their slight worsening of the breast's appearance, and the treatment costs would be lower.

At least one previous study had indicated that women who had wide excision of their DCIS and skipped radiation therapy had no higher risk of a recurrence DCIS than those who received it.

"This was a good hypothesis, but it certainly didn't work out in our study," said Jay Harris, M.D., chief of radiation oncology at Dana-Farber and the study's senior author. "The recurrence rate was surprise: We were all much more optimistic about not doing radiation."

The Dana-Farber research began in 1994 to test the hypothesis prospectively enrolling patients at the time of treatment for DCIS and monitoring them for recurrences over subsequent years. To qualify, patients were required to have a DCIS lesion less than an inch across. The research was headed by Julia Wong, M.D., a radiation oncologist at Dana-Farber and Brigham and Women's in Boston, who is giving an oral presentation of the work at the San Antonio conference.

But as the study progressed toward its intended goal of treating 200 patients, the rate of recurrence (both repeated

Contact: Janet Haley Dubow
Dana-Farber Cancer Institute

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