According to results recently published in the Journal of Clinical Oncology, radiation therapy following breast-conserving treatment reduces recurrences by nearly half among women with ductal carcinoma-in-situ (DCIS).
Ductal carcinoma in situ (DCIS) is the earliest possible clinical diagnosis of breast cancer. It is frequently diagnosed with screening mammography that has detected small areas of calcification in the breast. Patients rarely suspect that they have breast cancer with this stage of cancer.
In an attempt to provide the lowest rates of recurrence or development of invasive breast cancer, coupled with the fewest treatment-related side effects, researchers have been focused on determining optimal treatment of DCIS. A question prompting a great deal of interest is whether surgery with wide excision (surgical removal of the DCIS plus surrounding tissue) alone is sufficient treatment for DCIS, or whether surgery should be combined with radiation therapy.
Researchers affiliated with the European Organisation for Research and Treatment of Cancer (EORTC) conducted a clinical trial to evaluate the role of radiation therapy following surgery for DCIS. This trial included over 1,000 women who were diagnosed with DCIS between 1986 and 1996. Following complete surgical removal of their DCIS, patients were randomly assigned to receive either radiation therapy or no further therapy. Patients have now been followed for over 10 years.
- Recurrence-free survival was 85% for women treated with surgery/radiation therapy, versus only 74% for those treated with surgery only.
- Recurrences at or near the site of origin were reduced by 48% among patients who underwent radiation therapy.
- At 10 years, the rate of cancer spread to distant sites was only 4% in both groups of patients.
The researchers concluded that the addition of radiation therapy to surgery reduces the rate of cancer recurrences among women diagnosed with DCIS. However, it is important for patients with DCIS to discuss all of their individual risks and benefits of treatment with radiation therapy with their physician.
Reference: Bijker N, Meijnen P, Peterse JL, et al. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: Ten year results of European Organisation for Research and Treatment of Cancer Randomized Phase III Trial 10853-A study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. Journal of Clinical Oncology. 2006;24:3381-3387.
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