Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17.

Fisher, Bernard; Dignam, James J.; Wolmark, Norman; Mamounas, Eleftherios P.; Costantino, Joseph P.; Poller, William R.; Fisher, Edwin R.; Wickerham, D. Lawrence; Deutsch, Melvin; Margolese, Richard G.; Dimitrov, Nikolay V.; Kavanah, Maureen

doi:10.1200/jco.1998.16.2.441

Cited by 822 publications

(453 citation statements)

References 23 publications

(9 reference statements)

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“…This is approximately 6 years longer than the National Surgical Adjuvant Breast and Bowel Project, which included 391 DCIS patients treated by excision alone. 11 However, this rate is comparable to the rates of studies with longer follow-up, including the study by Sanders et al, 4 which revealed a recurrence rate of 25% at 10 years and 39% at 42 years. Our initial study, which included 151 patients diagnosed between 1983 and 2002, showed large tumor size, increased tumor grade, and presence of comedonecrosis to be associated with reduced time to disease recurrence on univariate analysis.…”

Section: Discussionsupporting

confidence: 66%

Prognostic markers and long-term outcomes in ductal carcinoma in situ of the breast treated with excision alone

Holmes

Lloyd

Chervoneva

et al. 2011

Cancer

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Section: Discussionsupporting

confidence: 66%

Prognostic markers and long-term outcomes in ductal carcinoma in situ of the breast treated with excision alone

Holmes

Lloyd

Chervoneva

et al. 2011

Cancer

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“…13,93 If the breast boost is omitted in these patients, the only available data indicate that the standard whole breast radiation therapy dose is 5,000 cGy at 200 cGy per fraction. 3,4,6,9,14,16,94 …”

Section: Elements In the Technique Of Irradiationmentioning

confidence: 99%

Standard for Breast Conservation Therapy in the Management of Invasive Breast Carcinoma

Morrow

Strom

Bassett

et al. 2002

CA: A Cancer Journal for Clinicians

298

165

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Multidisciplinary guidelines for management of invasive breast carcinoma from the American College of Radiology, the American College of Surgeons, the College of American Pathology, and the Society of Surgical Oncology have been updated to reflect the continuing advances in the diagnosis and treatment of invasive breast cancer. The guidelines provide a framework for clinical decision‐making for patients with invasive breast carcinoma based on review of relevant literature and include information on patient selection and evaluation, technical aspects of surgical treatment, techniques of irradiation, and follow‐up care.

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“…The National Surgical Adjuvant Breast and Bowel (NSABP) trial B17 was the first large randomized trial to compare excision alone to excision plus adjuvant radiation for DCIS of the breast [8]. This trial randomized 818 women with DCIS and uninvolved margins to wide local excision with or without adjuvant radiotherapy and showed a decrease in ipsilateral recurrence at 90 months follow-up from 27% to 12% with the addition of radiotherapy [9]. These NSABP results recently have been supplemented by early results of randomized trials from Europe [10,11].…”

Section: Discussionmentioning

confidence: 99%

Margin width as a determinant of local control with and without radiation therapy for ductal carcinoma in situ (DCIS) of the breast

et al. 2001

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SUMMARY In order to assess the utility of margin width in relation to other histopathologic features as a determinant of local control in ductal carcinoma in situ (DCIS) of the breast, we retrospectively examined the treatment of 109 breasts treated with (n ‫؍‬ 54) or without adjuvant radiotherapy (n ‫؍‬ 55). Median follow-up was 49 and 54 months for patients treated with excision alone (E) or excision plus adjuvant radiotherapy (E؉XRT), respectively. Cases treated with E؉XRT were significantly larger and had a trend towards closer surgical margins than those treated with E alone. For all cases, margin width <1 mm and lesion diameter >15 mm were significantly associated with increased local recurrence. Lesion size <15 mm was associated with no cases of local failure regardless of treatment arm. For lesions >15 mm in diameter, there was a significant decrease in 5-year local failure with E؉XRT compared to E alone (21% vs. 36%, P ‫؍‬ 0.03). Tumor margin >1 mm was associated with a low rate of 5-year local failure for either E alone or E؉XRT (10.9% vs. 4.6%, P ‫؍‬ NS). Tumor margin <1 mm had a high rate of local failure that was not significantly decreased by the addition of adjuvant radiotherapy. These results show that large diameter (>15mm) and close surgical margins (<1 mm) are the dominant risk factors for local recurrence in DCIS. E؉XRT significantly decreased local failure risk compared to E alone for large lesions but not for those with close margins.

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Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17.

Cited by 822 publications

References 23 publications

Prognostic markers and long-term outcomes in ductal carcinoma in situ of the breast treated with excision alone

Prognostic markers and long-term outcomes in ductal carcinoma in situ of the breast treated with excision alone

Standard for Breast Conservation Therapy in the Management of Invasive Breast Carcinoma

Margin width as a determinant of local control with and without radiation therapy for ductal carcinoma in situ (DCIS) of the breast

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