Radiation Essential to Controlling Long-Term Recurrence in Women With Early Form of Breast Cancer

Doctors have reported that rates of breast cancer recurrences continue to increase, even after 12 years, among patients with ductal carcinoma in situ (DCIS) who do not receive radiation therapy as part of their treatment regimen. These results were recently published in the Journal of Clinical Oncology.

DCIS is considered to be the earliest type of breast cancer where abnormal cells are found in the milk ducts. DCIS has not spread outside these ducts, but has the potential to become an invasive breast cancer if left untreated.

Due to the non-aggressive and non-invasive nature of DCIS, optimal treatment for the disease has been under evaluation. Healthcare providers try to provide optimal long-term survival outcomes for patients without over-treating (as this results in patients suffering from side effects without survival benefit). However, under-treatment of the disease can leave a patient at risk for developing invasive breast cancer.

Standard therapy for DCIS is the surgical removal of the cancer (excision), radiation therapy, and hormone therapy for hormone-positive breast cancers.

Due to the side effects associated with radiation therapy, researchers conducted a study to gather data on the long-term outcomes among women with DCIS who did not receive radiation as part of their initial treatment.

The study included over 660 women with DCIS who underwent surgical excision, hormone therapy if indicated and no radiation. Patients were divided into two groups: those considered at a low to intermediate risk of developing a recurrence (group A) and those considered to be at an intermediate to higher risk of developing a recurrence (group B).

Follow-up for these two groups of women was approximately 12 years. The overall incidence of recurrences in the same breast as the initial cancer (ipsilateral breast cancer recurrence) continued to increase as time progressed throughout the study time period.

Ipsilateral breast cancer recurrences occurred in 14.4% of women in group A, and 24.6% of women in group B.  In both groups, over 50% of cancer recurrences were invasive.

The researchers concluded that recurrence rates continue to increase, even after 12 years, among patients diagnosed with DCIS who do not receive radiation therapy following surgery as part of their initial treatment. The authors stated that “these data help inform the treatment-decision making process for patients and their physicians.”

Reference: Solin L, Gray R, Hughes L, et al. Surgical excision without radiation for ductal carcinoma in-situ of the breast: 12-year results from the ECOG-ACRIN E5194 study. Journal of Clinical Oncology. Published early on-line September 14, 2015. doi: 10.1200/JCO.2015.60.8558.

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