Radiotherapy for Ductal Carcinoma In Situ After Breast-Conserving Surgery

At 20-year follow-up, radiotherapy reduced absolute risk for local recurrence but did not improve survival; concerns about overtreatment remain.

The original SweDCIS trial of whole-breast radiotherapy versus observation after breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS) involved 1046 patients treated from 1987 to 1999 (Acta Oncol 2006; 45:536). In a prior update of that trial (J Clin Oncol 2008; 26:1247), the authors reported that, at 10 years, the use of radiotherapy reduced the absolute risk for local recurrence by 16% compared with observation (95% confidence interval, 10.3–21.6) but did not improve distant metastasis-free survival.

In a new update, the authors report that, at 20 years, the use of radiotherapy reduced the absolute risk for local recurrence by 12% (10% for in situ disease and 2% for invasive breast cancer; 95% confidence interval, 6.5–17.7) a…

Reviewing Author

Henry Mark Kuerer, MD, PhD, FACS

Disclosures

Speaker's BureauPhysicians’ Education Resource, LLC

RoyaltiesMcGraw-Hill Professional; UpToDate, Inc.

Editorial BoardsAnnals of Surgical Oncology

Leadership Positions in Professional SocietiesAmerican Society of Breast Surgeons (Chair, Publications Committee)