Boost radiotherapy in young women with ductal carcinoma in situ: a multicentre, retrospective study of the Rare Cancer Network

Omlin, Aurelius; Amichetti, Maurizio; Azria, D.; Cole, Bernard F.; Fourneret, Philippe; Poortmans, Philip; Naehrig, Diana; Miller, Robert C.; Krengli, Marco; Miguélez, Cristina; Morgan, D.A.L.; Goldberg, Hadassah; Scandolaro, Luciano; Gastelblum, Pauline; Ozşahin, Mahmut; Dohr, Dagmar; Christie, David; Oppitz, Ulrich; Abacıoğlu, Ufuk; Gruber, G.

doi:10.1016/s1470-2045(06)70765-3

Cited by 129 publications

(67 citation statements)

References 21 publications

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“…We examined the effect of age as a continuous variable and as a categorical variable using cut-points previously reported in the literature: less than 45 years, 45-50 years, and more than 50 years of age 8,11,13,14,19 . Actuarial results for any local recurrence, invasive local recurrence, local recurrence-free survival, invasive local recurrence-free survival, and overall survival were calculated by the Kaplan-Meier method.…”

Section: Discussionmentioning

confidence: 99%

Age at diagnosis predicts local recurrence in women treated with breast-conserving surgery and postoperative radiation therapy for ductal carcinoma in situ: a population-based outcomes analysis

Kong¹,

Narod²,

Taylor³

et al. 2013

Curr. Oncol.

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also significantly associated with invasive lr (hr: 1.6; 95% ci: 1.0 to 2.4; p = 0.04). ConclusionsAge at diagnosis is a strong predictor of lr in women with dcis after treatment with bcs and radiotherapy. KEY WORDSDuctal carcinoma in situ, age, recurrence, young patients, radiation BACKGROUNDDuctal carcinoma in situ (dcis) is a noninvasive form of breast cancer that is most often diagnosed during mammographic screening. Although dcis is not life-threatening, up to 20% of women with dcis can develop invasive breast cancer at 10 years, which is associated with an increased risk of breast cancer mortality [1][2][3][4][5][6] . The goals of treating dcis are to maximize breast conservation, optimize cosmesis, and prevent the development of invasive breast cancer. Most women with dcis are treated with breastconserving surgery (bcs), followed by whole-breast irradiation. Radiotherapy after bcs has been proved to reduce the rate of local recurrence (both in situ and invasive) 7-12 . Randomized and nonrandomized clinical trials report that after bcs and radiation, approximately 12%-15% of women will experience a local recurrence within 10 years, and 5%-10% will develop an invasive local recurrence [7][8][9][10][11][12] .It is important to identify factors associated with the development of local recurrence and subsequent invasive breast cancer, because women with such factors may be candidates for more extensive therapy. It has been suggested that younger age at diagnosis is a risk factor for local recurrence after treatment for dcis 7,12-14 . Multivariable analyses from randomized clinical trials suggest that the efficacy of radiation ABSTRACT PurposeThe main goal of treating ductal carcinoma in situ (dcis) is to prevent the development of invasive breast cancer. Most women are treated with breastconserving surgery (bcs) and radiotherapy. Age at diagnosis may be a risk factor for recurrence, leading to concerns that additional treatment may be necessary for younger women. We report a populationbased study of women with dcis treated with bcs and radiotherapy and an evaluation of the effect of age on local recurrence (lr). MethodsAll women diagnosed with dcis in Ontario from 1994 to 2003 were identified. Treatments and outcomes were collected through administrative databases and validated by chart review. Women treated with bcs and radiotherapy were included. Survival analyses were performed to evaluate the effect of age on outcomes. ResultsWe identified 5752 cases of dcis; 1607 women received bcs and radiotherapy. The median follow-up was 10.0 years. The 10-year cumulative lr rate was 27% for women younger than 45 years, 14% for women 45-50 years, and 11% for women more than 50 years of age (p < 0.0001). The 10-year cumulative invasive lr rate was 22% for women younger than 45 years, 10% for women 45-50 years, and 7% for women more than 50 years of age (p < 0.0001). On multivariate analyses, young age (<45 years) was significantly associated with lr and invasive lr [hazard ratio (hr) for lr: 2.6; 95% confidence interval...

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Section: Discussionmentioning

confidence: 99%

Age at diagnosis predicts local recurrence in women treated with breast-conserving surgery and postoperative radiation therapy for ductal carcinoma in situ: a population-based outcomes analysis

Kong¹,

Narod²,

Taylor³

et al. 2013

Curr. Oncol.

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“…In a multicentric, retrospective study, Omlin et al [92] demonstrated that an RT boost decreases LR in patients <45 years of age. The ten-year relapse-free survival was 46% for patients not receiving any RT, 72% for patients with RT without boost and 86% for patients receiving RT including a boost, thus suggesting that an RT boost should be considered in addition to surgery for BCS in patients with DIN.…”

Section: External Rtmentioning

confidence: 99%

The management of ductal intraepithelial neoplasia (DIN): open controversies and guidelines of the Istituto Europeo di Oncologia (IEO), Milan, Italy

Farante

Zurrida

Galimberti

et al. 2010

Breast Cancer Res Treat

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“…The major advantage correlated with the delivery of the boost was noticed in young women (≤ 39 years). (62) Another study by Wong et al confirmed the favorable effect of the radiation boost with no local recurrence observed among 79 patients receiving a boost, whereas 8 of 141 patients in the "no-boost" group experienced in breast LR after a median follow-up of 46 months (63). These results were obtained despite a higher risk for local recurrence in the boost group (positive or less than 1 mm margins in 48% of cases -"boost group" vs 8% -"no boost group").…”

Section: Role Of a Tumor Bed Boost In Dcismentioning

confidence: 91%

Radiation Therapy Following Breast Conserving Surgery for Ductal Carcinoma in situ: Yes or No?

Stoleru¹,

Stoleru²

2017

chr

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RezumatCarcinomul ductal in situ al sânului este un precursor non-invaziv al cancerului mamar şi este reprezentat de un grup de leziuni cu potenţial malign variabil. Tratamentul local optim pentru pacientele cu carcinom ductal in situ rãmane un subiect controversat, în ciuda rezultatelor provenite din mai multe trialuri randomizate. Radioterapia care urmeazã intervenţiei chirurgicale conservatoare reduce aproximativ la jumãtate riscul de recidivã localã, dar nu are impact în ceea ce priveşte supravieţuirea pe termen lung. Studiile clinice desfãşurate pânã în prezent nu au putut identifica un subgrup de paciente cu carcinom ductal in situ cu risc scãzut, la care sã se poata renunţa în siguranţã la radioterapie, dupã intervenţia chirurgicala conservatoare. În lucrare sunt prezentate rezultate ale studiilor clinice în care s-a utilizat chirurgia conservatoare a sânului urmatã sau nu de radioterapie. Alte subiecte abordate se referã la stabilirea indicaţiei terapeutice în cazul carcinomului ductal in situ cu risc scãzut şi la noi tendinţe în radioterapia pentru carcinomul ductal in situ. Review Articlebreast cancerand represents a heterogenous group of lesions with different malignant potential. Despite several randomized trials, there is still controversy regarding the optimal local treatment for DCIS patients. The addition of radiotherapy after breast conserving surgery approximately halves the local recurrence risk but has no impact on long-term survival. Clinical studies failed to identify a low risk subgroup of DCIS patients treated with breast conserving surgery in whom radiotherapy can be safely omitted. Results of clinical trials of breast conserving surgery ± radiotherapy are summarized. Treatment decision making in low risk DCIS and current tendencies in the radiotherapy for DCIS are other issues addressed in this paper.

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Boost radiotherapy in young women with ductal carcinoma in situ: a multicentre, retrospective study of the Rare Cancer Network

Cited by 129 publications

References 21 publications

Age at diagnosis predicts local recurrence in women treated with breast-conserving surgery and postoperative radiation therapy for ductal carcinoma in situ: a population-based outcomes analysis

Age at diagnosis predicts local recurrence in women treated with breast-conserving surgery and postoperative radiation therapy for ductal carcinoma in situ: a population-based outcomes analysis

The management of ductal intraepithelial neoplasia (DIN): open controversies and guidelines of the Istituto Europeo di Oncologia (IEO), Milan, Italy

Radiation Therapy Following Breast Conserving Surgery for Ductal Carcinoma in situ: Yes or No?

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