TY - JOUR
T1 - Radiotherapy after mastectomy for screen-detected ductal carcinoma in situ
AU - Clements, K.
AU - Dodwell, D.
AU - Lawrence, Gillian
AU - Ball, G.
AU - Francis, A.
AU - Pinder, S.
AU - Sawyer, E.
AU - Wallis, M.
AU - Thompson, A. M.
N1 - Publisher Copyright:
© 2015 Elsevier Ltd.
PY - 2015/10
Y1 - 2015/10
N2 - Background A role for radiotherapy after mastectomy for ductal carcinoma in situ (DCIS) is unclear. Using a prospective audit of DCIS detected through the NHS Breast Screening Programme we sought to determine a rationale for the use of post mastectomy radiotherapy for DCIS. Methods Over a nine year period, from 9972 patients with screen-detected DCIS and complete surgical, pathology, radiotherapy and follow up data, 2944 women underwent mastectomy for DCIS of whom 33 (1.1%) received radiotherapy. Results Use of post mastectomy radiotherapy was significantly associated with a close (<1 mm) pathology margin (χ2(1) 95.81; p < 0.00001), DCIS size (χ2 (3) 16.96; p < 0.001) and the presence of microinvasion (χ2(1) 3.92; p < 0.05). At a median follow up 61 months, no woman who received radiotherapy had an ipsilateral further event, and only 1/33 women (3.0%) had a contralateral event. Of the women known not to have had radiotherapy post mastectomy, 45/2894 (1.6%) had an ipsilateral further event and 83 (2.9%) had a contralateral event. Conclusion Recurrence following mastectomy for DCIS is rare. A close (<1 mm) margin, large tumour size and microinvasion, may merit radiotherapy to reduce ipsilateral recurrence.
AB - Background A role for radiotherapy after mastectomy for ductal carcinoma in situ (DCIS) is unclear. Using a prospective audit of DCIS detected through the NHS Breast Screening Programme we sought to determine a rationale for the use of post mastectomy radiotherapy for DCIS. Methods Over a nine year period, from 9972 patients with screen-detected DCIS and complete surgical, pathology, radiotherapy and follow up data, 2944 women underwent mastectomy for DCIS of whom 33 (1.1%) received radiotherapy. Results Use of post mastectomy radiotherapy was significantly associated with a close (<1 mm) pathology margin (χ2(1) 95.81; p < 0.00001), DCIS size (χ2 (3) 16.96; p < 0.001) and the presence of microinvasion (χ2(1) 3.92; p < 0.05). At a median follow up 61 months, no woman who received radiotherapy had an ipsilateral further event, and only 1/33 women (3.0%) had a contralateral event. Of the women known not to have had radiotherapy post mastectomy, 45/2894 (1.6%) had an ipsilateral further event and 83 (2.9%) had a contralateral event. Conclusion Recurrence following mastectomy for DCIS is rare. A close (<1 mm) margin, large tumour size and microinvasion, may merit radiotherapy to reduce ipsilateral recurrence.
KW - Breast cancer
KW - DCIS
KW - Mastectomy
KW - Radiotherapy
KW - Sloane project
UR - http://www.scopus.com/inward/record.url?scp=84943817170&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2015.07.021
DO - 10.1016/j.ejso.2015.07.021
M3 - Article
C2 - 26314790
AN - SCOPUS:84943817170
SN - 0748-7983
VL - 41
SP - 1406
EP - 1410
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 10
M1 - 4120
ER -