Is Radiation Indicated in Patients With Ductal Carcinoma In Situ and Close or Positive Mastectomy Margins?
Purpose Resection margin status is one of the most significant factors for local recurrence in patients with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery with or without radiation. However, its impact on chest wall recurrence in patients treated with mastectomy is unknown....
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| creator | Chan, Linda W., M.D Rabban, Joseph, M.D., M.P.H Hwang, E. Shelley, M.D., M.P.H Bevan, Alison, M.D., Ph.D Alvarado, Michael, M.D Ewing, Cheryl, M.D Esserman, Laura, M.D., M.B.A Fowble, Barbara, M.D |
| description | Purpose Resection margin status is one of the most significant factors for local recurrence in patients with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery with or without radiation. However, its impact on chest wall recurrence in patients treated with mastectomy is unknown. The purpose of this study was to determine chest wall recurrence rates in women with DCIS and close (5 cm or diffuse disease. Median width of the close final margin was 2 mm. Nineteen patients had margins of |
| doi_str_mv | 10.1016/j.ijrobp.2010.01.044 |
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| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_21491743</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0360301610001446</els_id><sourcerecordid>1687664907</sourcerecordid><originalsourceid>FETCH-LOGICAL-c507t-e7f836085fec46840699f3e87f5fedef3d9190d0bcfc58424a074e0beb47f69a3</originalsourceid><addsrcrecordid>eNqFkl-L1DAUxYso7uzqNxAJiKwvM960adO-rMj4b2DFxVX0LWTSWze1TcYkXZhv7y0zKvigTwmX303Ovedk2SMOKw68et6vbB_8drfKgUrAVyDEnWzBa9ksi7L8ejdbQFHBsiD4JDuNsQcAzqW4n53kUImqlnyR9ZvIPurW6mS9YxvXWqMTtsw6dkU1dCmyLzbdsFeTSXpgax2MdX7UxLJrmyamXcvWg4_IfGBXPtpkb5G91zGhSX7c0zV8sy6-eJDd6_QQ8eHxPMs-v3n9af1uefnh7Wb98nJpSpBpibKrSXdddmhIpICqaboCa9lRpcWuaBveQAtb05myFrnQIAXCFrdCdlWji7PsyeFdH5NV0VgScmO8c6RH5Vw0tIOCqPMDtQv-x4QxqdFGg8OgHfopqrrisikaWRP57J8kp01WlWhAEioOqAk-xoCd2gU76rBXHNTsmurVwTU1u6aAK3KN2h4ff5i2I7a_m37ZRMDTI6Cj0UMXtDM2_uEEL0XOZ6kXBw5pv7cWwzw-OoOtDfP0rbf_U_L3A2awjjIxfMc9xt5PwZF3iquYK1DXc8LmgPE5W0JUxU9zC8sU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1687664907</pqid></control><display><type>article</type><title>Is Radiation Indicated in Patients With Ductal Carcinoma In Situ and Close or Positive Mastectomy Margins?</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Chan, Linda W., M.D ; Rabban, Joseph, M.D., M.P.H ; Hwang, E. Shelley, M.D., M.P.H ; Bevan, Alison, M.D., Ph.D ; Alvarado, Michael, M.D ; Ewing, Cheryl, M.D ; Esserman, Laura, M.D., M.B.A ; Fowble, Barbara, M.D</creator><creatorcontrib>Chan, Linda W., M.D ; Rabban, Joseph, M.D., M.P.H ; Hwang, E. Shelley, M.D., M.P.H ; Bevan, Alison, M.D., Ph.D ; Alvarado, Michael, M.D ; Ewing, Cheryl, M.D ; Esserman, Laura, M.D., M.B.A ; Fowble, Barbara, M.D</creatorcontrib><description>Purpose Resection margin status is one of the most significant factors for local recurrence in patients with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery with or without radiation. However, its impact on chest wall recurrence in patients treated with mastectomy is unknown. The purpose of this study was to determine chest wall recurrence rates in women with DCIS and close (<5 mm) or positive mastectomy margins in order to evaluate the potential role of radiation therapy. Methods and Materials Between 1985 and 2005, 193 women underwent mastectomy for DCIS. Fifty-five patients had a close final margin, and 4 patients had a positive final margin. Axillary surgery was performed in 17 patients. Median follow-up was 8 years. Formal pathology review was conducted to measure and verify margin status. Nuclear grade, architectural pattern, and presence or absence of necrosis was recorded. Results Median pathologic size of the DCIS in the mastectomy specimen was 4.5 cm. Twenty-two patients had DCIS of >5 cm or diffuse disease. Median width of the close final margin was 2 mm. Nineteen patients had margins of <1 mm. One of these 59 patients experienced a chest wall recurrence with regional adenopathy, followed by distant metastases 2 years following skin-sparing mastectomy. The DCIS was high-grade, 4 cm, with a 5-mm deep margin. A second patient developed an invasive cancer in the chest wall 20 years after her mastectomy for DCIS. This cancer was considered a new primary site arising in residual breast tissue. Conclusions The risk of chest wall recurrence in this series of patients is 1.7% for all patients and 3.3% for high-grade DCIS. One out of 20 (5%) patients undergoing skin sparing or total skin-sparing mastectomy experienced a chest wall recurrence. This risk of a chest wall recurrence appears sufficiently low not to warrant a recommendation for postmastectomy radiation therapy for patients with margins of <5 mm. There were too few patients with positive margins to draw any firm conclusions.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2010.01.044</identifier><identifier>PMID: 20646871</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Axilla ; Biological and medical sciences ; BODY ; Breast Neoplasms - pathology ; Breast Neoplasms - radiotherapy ; Breast Neoplasms - surgery ; Carcinoma in Situ - pathology ; Carcinoma in Situ - radiotherapy ; Carcinoma in Situ - surgery ; Carcinoma, Ductal, Breast - pathology ; Carcinoma, Ductal, Breast - radiotherapy ; Carcinoma, Ductal, Breast - surgery ; CARCINOMAS ; CHEST ; DISEASES ; Ductal carcinoma in situ ; Female ; GLANDS ; Hematology, Oncology and Palliative Medicine ; Humans ; Local recurrence ; Lymph Node Excision - methods ; MAMMARY GLANDS ; Margin status ; Mastectomy ; Mastectomy, Segmental - methods ; Medical sciences ; MEDICINE ; Middle Aged ; Neoplasm Recurrence, Local - pathology ; Neoplasm, Residual ; NEOPLASMS ; NUCLEAR MEDICINE ; ORGANS ; RADIOLOGY ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy, Adjuvant ; SURGERY ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the genital tract and mammary gland ; THERAPY ; Thoracic Wall ; Tumor Burden ; WALLS</subject><ispartof>International journal of radiation oncology, biology, physics, 2011-05, Vol.80 (1), p.25-30</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-e7f836085fec46840699f3e87f5fedef3d9190d0bcfc58424a074e0beb47f69a3</citedby><cites>FETCH-LOGICAL-c507t-e7f836085fec46840699f3e87f5fedef3d9190d0bcfc58424a074e0beb47f69a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301610001446$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24154218$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20646871$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21491743$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Linda W., M.D</creatorcontrib><creatorcontrib>Rabban, Joseph, M.D., M.P.H</creatorcontrib><creatorcontrib>Hwang, E. Shelley, M.D., M.P.H</creatorcontrib><creatorcontrib>Bevan, Alison, M.D., Ph.D</creatorcontrib><creatorcontrib>Alvarado, Michael, M.D</creatorcontrib><creatorcontrib>Ewing, Cheryl, M.D</creatorcontrib><creatorcontrib>Esserman, Laura, M.D., M.B.A</creatorcontrib><creatorcontrib>Fowble, Barbara, M.D</creatorcontrib><title>Is Radiation Indicated in Patients With Ductal Carcinoma In Situ and Close or Positive Mastectomy Margins?</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose Resection margin status is one of the most significant factors for local recurrence in patients with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery with or without radiation. However, its impact on chest wall recurrence in patients treated with mastectomy is unknown. The purpose of this study was to determine chest wall recurrence rates in women with DCIS and close (<5 mm) or positive mastectomy margins in order to evaluate the potential role of radiation therapy. Methods and Materials Between 1985 and 2005, 193 women underwent mastectomy for DCIS. Fifty-five patients had a close final margin, and 4 patients had a positive final margin. Axillary surgery was performed in 17 patients. Median follow-up was 8 years. Formal pathology review was conducted to measure and verify margin status. Nuclear grade, architectural pattern, and presence or absence of necrosis was recorded. Results Median pathologic size of the DCIS in the mastectomy specimen was 4.5 cm. Twenty-two patients had DCIS of >5 cm or diffuse disease. Median width of the close final margin was 2 mm. Nineteen patients had margins of <1 mm. One of these 59 patients experienced a chest wall recurrence with regional adenopathy, followed by distant metastases 2 years following skin-sparing mastectomy. The DCIS was high-grade, 4 cm, with a 5-mm deep margin. A second patient developed an invasive cancer in the chest wall 20 years after her mastectomy for DCIS. This cancer was considered a new primary site arising in residual breast tissue. Conclusions The risk of chest wall recurrence in this series of patients is 1.7% for all patients and 3.3% for high-grade DCIS. One out of 20 (5%) patients undergoing skin sparing or total skin-sparing mastectomy experienced a chest wall recurrence. This risk of a chest wall recurrence appears sufficiently low not to warrant a recommendation for postmastectomy radiation therapy for patients with margins of <5 mm. There were too few patients with positive margins to draw any firm conclusions.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Axilla</subject><subject>Biological and medical sciences</subject><subject>BODY</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Breast Neoplasms - surgery</subject><subject>Carcinoma in Situ - pathology</subject><subject>Carcinoma in Situ - radiotherapy</subject><subject>Carcinoma in Situ - surgery</subject><subject>Carcinoma, Ductal, Breast - pathology</subject><subject>Carcinoma, Ductal, Breast - radiotherapy</subject><subject>Carcinoma, Ductal, Breast - surgery</subject><subject>CARCINOMAS</subject><subject>CHEST</subject><subject>DISEASES</subject><subject>Ductal carcinoma in situ</subject><subject>Female</subject><subject>GLANDS</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Local recurrence</subject><subject>Lymph Node Excision - methods</subject><subject>MAMMARY GLANDS</subject><subject>Margin status</subject><subject>Mastectomy</subject><subject>Mastectomy, Segmental - methods</subject><subject>Medical sciences</subject><subject>MEDICINE</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm, Residual</subject><subject>NEOPLASMS</subject><subject>NUCLEAR MEDICINE</subject><subject>ORGANS</subject><subject>RADIOLOGY</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy, Adjuvant</subject><subject>SURGERY</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the genital tract and mammary gland</subject><subject>THERAPY</subject><subject>Thoracic Wall</subject><subject>Tumor Burden</subject><subject>WALLS</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl-L1DAUxYso7uzqNxAJiKwvM960adO-rMj4b2DFxVX0LWTSWze1TcYkXZhv7y0zKvigTwmX303Ovedk2SMOKw68et6vbB_8drfKgUrAVyDEnWzBa9ksi7L8ejdbQFHBsiD4JDuNsQcAzqW4n53kUImqlnyR9ZvIPurW6mS9YxvXWqMTtsw6dkU1dCmyLzbdsFeTSXpgax2MdX7UxLJrmyamXcvWg4_IfGBXPtpkb5G91zGhSX7c0zV8sy6-eJDd6_QQ8eHxPMs-v3n9af1uefnh7Wb98nJpSpBpibKrSXdddmhIpICqaboCa9lRpcWuaBveQAtb05myFrnQIAXCFrdCdlWji7PsyeFdH5NV0VgScmO8c6RH5Vw0tIOCqPMDtQv-x4QxqdFGg8OgHfopqrrisikaWRP57J8kp01WlWhAEioOqAk-xoCd2gU76rBXHNTsmurVwTU1u6aAK3KN2h4ff5i2I7a_m37ZRMDTI6Cj0UMXtDM2_uEEL0XOZ6kXBw5pv7cWwzw-OoOtDfP0rbf_U_L3A2awjjIxfMc9xt5PwZF3iquYK1DXc8LmgPE5W0JUxU9zC8sU</recordid><startdate>20110501</startdate><enddate>20110501</enddate><creator>Chan, Linda W., M.D</creator><creator>Rabban, Joseph, M.D., M.P.H</creator><creator>Hwang, E. Shelley, M.D., M.P.H</creator><creator>Bevan, Alison, M.D., Ph.D</creator><creator>Alvarado, Michael, M.D</creator><creator>Ewing, Cheryl, M.D</creator><creator>Esserman, Laura, M.D., M.B.A</creator><creator>Fowble, Barbara, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20110501</creationdate><title>Is Radiation Indicated in Patients With Ductal Carcinoma In Situ and Close or Positive Mastectomy Margins?</title><author>Chan, Linda W., M.D ; Rabban, Joseph, M.D., M.P.H ; Hwang, E. Shelley, M.D., M.P.H ; Bevan, Alison, M.D., Ph.D ; Alvarado, Michael, M.D ; Ewing, Cheryl, M.D ; Esserman, Laura, M.D., M.B.A ; Fowble, Barbara, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-e7f836085fec46840699f3e87f5fedef3d9190d0bcfc58424a074e0beb47f69a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Axilla</topic><topic>Biological and medical sciences</topic><topic>BODY</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Breast Neoplasms - surgery</topic><topic>Carcinoma in Situ - pathology</topic><topic>Carcinoma in Situ - radiotherapy</topic><topic>Carcinoma in Situ - surgery</topic><topic>Carcinoma, Ductal, Breast - pathology</topic><topic>Carcinoma, Ductal, Breast - radiotherapy</topic><topic>Carcinoma, Ductal, Breast - surgery</topic><topic>CARCINOMAS</topic><topic>CHEST</topic><topic>DISEASES</topic><topic>Ductal carcinoma in situ</topic><topic>Female</topic><topic>GLANDS</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Local recurrence</topic><topic>Lymph Node Excision - methods</topic><topic>MAMMARY GLANDS</topic><topic>Margin status</topic><topic>Mastectomy</topic><topic>Mastectomy, Segmental - methods</topic><topic>Medical sciences</topic><topic>MEDICINE</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm, Residual</topic><topic>NEOPLASMS</topic><topic>NUCLEAR MEDICINE</topic><topic>ORGANS</topic><topic>RADIOLOGY</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy, Adjuvant</topic><topic>SURGERY</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the genital tract and mammary gland</topic><topic>THERAPY</topic><topic>Thoracic Wall</topic><topic>Tumor Burden</topic><topic>WALLS</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Linda W., M.D</creatorcontrib><creatorcontrib>Rabban, Joseph, M.D., M.P.H</creatorcontrib><creatorcontrib>Hwang, E. Shelley, M.D., M.P.H</creatorcontrib><creatorcontrib>Bevan, Alison, M.D., Ph.D</creatorcontrib><creatorcontrib>Alvarado, Michael, M.D</creatorcontrib><creatorcontrib>Ewing, Cheryl, M.D</creatorcontrib><creatorcontrib>Esserman, Laura, M.D., M.B.A</creatorcontrib><creatorcontrib>Fowble, Barbara, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Linda W., M.D</au><au>Rabban, Joseph, M.D., M.P.H</au><au>Hwang, E. Shelley, M.D., M.P.H</au><au>Bevan, Alison, M.D., Ph.D</au><au>Alvarado, Michael, M.D</au><au>Ewing, Cheryl, M.D</au><au>Esserman, Laura, M.D., M.B.A</au><au>Fowble, Barbara, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is Radiation Indicated in Patients With Ductal Carcinoma In Situ and Close or Positive Mastectomy Margins?</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2011-05-01</date><risdate>2011</risdate><volume>80</volume><issue>1</issue><spage>25</spage><epage>30</epage><pages>25-30</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose Resection margin status is one of the most significant factors for local recurrence in patients with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery with or without radiation. However, its impact on chest wall recurrence in patients treated with mastectomy is unknown. The purpose of this study was to determine chest wall recurrence rates in women with DCIS and close (<5 mm) or positive mastectomy margins in order to evaluate the potential role of radiation therapy. Methods and Materials Between 1985 and 2005, 193 women underwent mastectomy for DCIS. Fifty-five patients had a close final margin, and 4 patients had a positive final margin. Axillary surgery was performed in 17 patients. Median follow-up was 8 years. Formal pathology review was conducted to measure and verify margin status. Nuclear grade, architectural pattern, and presence or absence of necrosis was recorded. Results Median pathologic size of the DCIS in the mastectomy specimen was 4.5 cm. Twenty-two patients had DCIS of >5 cm or diffuse disease. Median width of the close final margin was 2 mm. Nineteen patients had margins of <1 mm. One of these 59 patients experienced a chest wall recurrence with regional adenopathy, followed by distant metastases 2 years following skin-sparing mastectomy. The DCIS was high-grade, 4 cm, with a 5-mm deep margin. A second patient developed an invasive cancer in the chest wall 20 years after her mastectomy for DCIS. This cancer was considered a new primary site arising in residual breast tissue. Conclusions The risk of chest wall recurrence in this series of patients is 1.7% for all patients and 3.3% for high-grade DCIS. One out of 20 (5%) patients undergoing skin sparing or total skin-sparing mastectomy experienced a chest wall recurrence. This risk of a chest wall recurrence appears sufficiently low not to warrant a recommendation for postmastectomy radiation therapy for patients with margins of <5 mm. There were too few patients with positive margins to draw any firm conclusions.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20646871</pmid><doi>10.1016/j.ijrobp.2010.01.044</doi><tpages>6</tpages></addata></record> |
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| ispartof | International journal of radiation oncology, biology, physics, 2011-05, Vol.80 (1), p.25-30 |
| issn | 0360-3016 1879-355X |
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| subjects | Adult Aged Aged, 80 and over Axilla Biological and medical sciences BODY Breast Neoplasms - pathology Breast Neoplasms - radiotherapy Breast Neoplasms - surgery Carcinoma in Situ - pathology Carcinoma in Situ - radiotherapy Carcinoma in Situ - surgery Carcinoma, Ductal, Breast - pathology Carcinoma, Ductal, Breast - radiotherapy Carcinoma, Ductal, Breast - surgery CARCINOMAS CHEST DISEASES Ductal carcinoma in situ Female GLANDS Hematology, Oncology and Palliative Medicine Humans Local recurrence Lymph Node Excision - methods MAMMARY GLANDS Margin status Mastectomy Mastectomy, Segmental - methods Medical sciences MEDICINE Middle Aged Neoplasm Recurrence, Local - pathology Neoplasm, Residual NEOPLASMS NUCLEAR MEDICINE ORGANS RADIOLOGY RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy, Adjuvant SURGERY Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the genital tract and mammary gland THERAPY Thoracic Wall Tumor Burden WALLS |
| title | Is Radiation Indicated in Patients With Ductal Carcinoma In Situ and Close or Positive Mastectomy Margins? |
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