Radiotherapy after mastectomy for screen-detected ductal carcinoma in situ
Abstract Background A role for radiotherapy after mastectomy for ductal carcinoma in situ (DCIS) is unclear. Using a prospective audit of DCIS detected through the NHS Breast Screening Programme we sought to determine a rationale for the use of post mastectomy radiotherapy for DCIS. Methods Over a n...
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| Veröffentlicht in: | European journal of surgical oncology 2015-10, Vol.41 (10), p.1406-1410 |
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| creator | Clements, K Dodwell, D Lawrence, G Ball, G Francis, A Pinder, S Sawyer, E Wallis, M Thompson, A.M |
| description | Abstract Background A role for radiotherapy after mastectomy for ductal carcinoma in situ (DCIS) is unclear. Using a prospective audit of DCIS detected through the NHS Breast Screening Programme we sought to determine a rationale for the use of post mastectomy radiotherapy for DCIS. Methods Over a nine year period, from 9972 patients with screen-detected DCIS and complete surgical, pathology, radiotherapy and follow up data, 2944 women underwent mastectomy for DCIS of whom 33 (1.1%) received radiotherapy. Results Use of post mastectomy radiotherapy was significantly associated with a close ( |
| doi_str_mv | 10.1016/j.ejso.2015.07.021 |
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Using a prospective audit of DCIS detected through the NHS Breast Screening Programme we sought to determine a rationale for the use of post mastectomy radiotherapy for DCIS. Methods Over a nine year period, from 9972 patients with screen-detected DCIS and complete surgical, pathology, radiotherapy and follow up data, 2944 women underwent mastectomy for DCIS of whom 33 (1.1%) received radiotherapy. Results Use of post mastectomy radiotherapy was significantly associated with a close (<1 mm) pathology margin (χ2 (1) 95.81; p < 0.00001), DCIS size (χ2 (3) 16.96; p < 0.001) and the presence of microinvasion (χ2 (1) 3.92; p < 0.05). At a median follow up 61 months, no woman who received radiotherapy had an ipsilateral further event, and only 1/33 women (3.0%) had a contralateral event. Of the women known not to have had radiotherapy post mastectomy, 45/2894 (1.6%) had an ipsilateral further event and 83 (2.9%) had a contralateral event. Conclusion Recurrence following mastectomy for DCIS is rare. A close (<1 mm) margin, large tumour size and microinvasion, may merit radiotherapy to reduce ipsilateral recurrence.</description><identifier>ISSN: 0748-7983</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2015.07.021</identifier><identifier>PMID: 26314790</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aged ; Breast cancer ; Breast Neoplasms - diagnosis ; Breast Neoplasms - radiotherapy ; Breast Neoplasms - surgery ; Carcinoma, Intraductal, Noninfiltrating - diagnosis ; Carcinoma, Intraductal, Noninfiltrating - radiotherapy ; Carcinoma, Intraductal, Noninfiltrating - surgery ; Cohort Studies ; DCIS ; Disease-Free Survival ; Early Detection of Cancer ; Female ; Hematology, Oncology and Palliative Medicine ; Humans ; Mastectomy ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm, Residual ; Prospective Studies ; Radiotherapy ; Radiotherapy, Adjuvant - methods ; Sloane project ; Surgery</subject><ispartof>European journal of surgical oncology, 2015-10, Vol.41 (10), p.1406-1410</ispartof><rights>Elsevier Ltd</rights><rights>2015 Elsevier Ltd</rights><rights>Copyright © 2015 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-fb4edbd2c32cf059106539d739638d428a60607f5fabbb9c230f59b9e22271dd3</citedby><cites>FETCH-LOGICAL-c525t-fb4edbd2c32cf059106539d739638d428a60607f5fabbb9c230f59b9e22271dd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejso.2015.07.021$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26314790$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clements, K</creatorcontrib><creatorcontrib>Dodwell, D</creatorcontrib><creatorcontrib>Lawrence, G</creatorcontrib><creatorcontrib>Ball, G</creatorcontrib><creatorcontrib>Francis, A</creatorcontrib><creatorcontrib>Pinder, S</creatorcontrib><creatorcontrib>Sawyer, E</creatorcontrib><creatorcontrib>Wallis, M</creatorcontrib><creatorcontrib>Thompson, A.M</creatorcontrib><creatorcontrib>Sloane Project Steering Group</creatorcontrib><title>Radiotherapy after mastectomy for screen-detected ductal carcinoma in situ</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>Abstract Background A role for radiotherapy after mastectomy for ductal carcinoma in situ (DCIS) is unclear. Using a prospective audit of DCIS detected through the NHS Breast Screening Programme we sought to determine a rationale for the use of post mastectomy radiotherapy for DCIS. Methods Over a nine year period, from 9972 patients with screen-detected DCIS and complete surgical, pathology, radiotherapy and follow up data, 2944 women underwent mastectomy for DCIS of whom 33 (1.1%) received radiotherapy. Results Use of post mastectomy radiotherapy was significantly associated with a close (<1 mm) pathology margin (χ2 (1) 95.81; p < 0.00001), DCIS size (χ2 (3) 16.96; p < 0.001) and the presence of microinvasion (χ2 (1) 3.92; p < 0.05). At a median follow up 61 months, no woman who received radiotherapy had an ipsilateral further event, and only 1/33 women (3.0%) had a contralateral event. Of the women known not to have had radiotherapy post mastectomy, 45/2894 (1.6%) had an ipsilateral further event and 83 (2.9%) had a contralateral event. Conclusion Recurrence following mastectomy for DCIS is rare. A close (<1 mm) margin, large tumour size and microinvasion, may merit radiotherapy to reduce ipsilateral recurrence.</description><subject>Aged</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - radiotherapy</subject><subject>Breast Neoplasms - surgery</subject><subject>Carcinoma, Intraductal, Noninfiltrating - diagnosis</subject><subject>Carcinoma, Intraductal, Noninfiltrating - radiotherapy</subject><subject>Carcinoma, Intraductal, Noninfiltrating - surgery</subject><subject>Cohort Studies</subject><subject>DCIS</subject><subject>Disease-Free Survival</subject><subject>Early Detection of Cancer</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Mastectomy</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasm, Residual</subject><subject>Prospective Studies</subject><subject>Radiotherapy</subject><subject>Radiotherapy, Adjuvant - methods</subject><subject>Sloane project</subject><subject>Surgery</subject><issn>0748-7983</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2r1TAQhoMo3uPVP-BCunTTOpk0zQmIIBc_uSD4sQ5pMsHUtjkmrXD-vS3n6sKFq4HheV-YZxh7yqHhwLsXQ0NDSQ0Clw2oBpDfYwcuBdbIpbrPDqDaY630UVyxR6UMAKCF0g_ZFXaCt0rDgX38bH1My3fK9nSubFgoV5MtC7klTecqpFwVl4nm2tO-JF_51S12rJzNLs5pslWcqxKX9TF7EOxY6MndvGbf3r75evO-vv307sPN69vaSZRLHfqWfO_RCXQBpObQSaG9EroTR9_i0XbQgQoy2L7vtUMBQepeEyIq7r24Zs8vvaecfq5UFjPF4mgc7UxpLYYr5EICCr6heEFdTqVkCuaU42Tz2XAwu0MzmN2h2R0aUGZzuIWe3fWv_UT-b-SPtA14eQFou_JXpGyKizQ78jFvioxP8f_9r_6JuzHO0dnxB52pDGnN8-bPcFPQgPmyf3F_IpcAXduB-A3QNJez</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Clements, K</creator><creator>Dodwell, D</creator><creator>Lawrence, G</creator><creator>Ball, G</creator><creator>Francis, A</creator><creator>Pinder, S</creator><creator>Sawyer, E</creator><creator>Wallis, M</creator><creator>Thompson, A.M</creator><general>Elsevier Ltd</general><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>7X8</scope></search><sort><creationdate>20151001</creationdate><title>Radiotherapy after mastectomy for screen-detected ductal carcinoma in situ</title><author>Clements, K ; Dodwell, D ; Lawrence, G ; Ball, G ; Francis, A ; Pinder, S ; Sawyer, E ; Wallis, M ; Thompson, A.M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-fb4edbd2c32cf059106539d739638d428a60607f5fabbb9c230f59b9e22271dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - radiotherapy</topic><topic>Breast Neoplasms - surgery</topic><topic>Carcinoma, Intraductal, Noninfiltrating - diagnosis</topic><topic>Carcinoma, Intraductal, Noninfiltrating - radiotherapy</topic><topic>Carcinoma, Intraductal, Noninfiltrating - surgery</topic><topic>Cohort Studies</topic><topic>DCIS</topic><topic>Disease-Free Survival</topic><topic>Early Detection of Cancer</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Mastectomy</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasm, Residual</topic><topic>Prospective Studies</topic><topic>Radiotherapy</topic><topic>Radiotherapy, Adjuvant - methods</topic><topic>Sloane project</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Clements, K</creatorcontrib><creatorcontrib>Dodwell, D</creatorcontrib><creatorcontrib>Lawrence, G</creatorcontrib><creatorcontrib>Ball, G</creatorcontrib><creatorcontrib>Francis, A</creatorcontrib><creatorcontrib>Pinder, S</creatorcontrib><creatorcontrib>Sawyer, E</creatorcontrib><creatorcontrib>Wallis, M</creatorcontrib><creatorcontrib>Thompson, A.M</creatorcontrib><creatorcontrib>Sloane Project Steering Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Clements, K</au><au>Dodwell, D</au><au>Lawrence, G</au><au>Ball, G</au><au>Francis, A</au><au>Pinder, S</au><au>Sawyer, E</au><au>Wallis, M</au><au>Thompson, A.M</au><aucorp>Sloane Project Steering Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiotherapy after mastectomy for screen-detected ductal carcinoma in situ</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>41</volume><issue>10</issue><spage>1406</spage><epage>1410</epage><pages>1406-1410</pages><issn>0748-7983</issn><eissn>1532-2157</eissn><abstract>Abstract Background A role for radiotherapy after mastectomy for ductal carcinoma in situ (DCIS) is unclear. Using a prospective audit of DCIS detected through the NHS Breast Screening Programme we sought to determine a rationale for the use of post mastectomy radiotherapy for DCIS. Methods Over a nine year period, from 9972 patients with screen-detected DCIS and complete surgical, pathology, radiotherapy and follow up data, 2944 women underwent mastectomy for DCIS of whom 33 (1.1%) received radiotherapy. Results Use of post mastectomy radiotherapy was significantly associated with a close (<1 mm) pathology margin (χ2 (1) 95.81; p < 0.00001), DCIS size (χ2 (3) 16.96; p < 0.001) and the presence of microinvasion (χ2 (1) 3.92; p < 0.05). At a median follow up 61 months, no woman who received radiotherapy had an ipsilateral further event, and only 1/33 women (3.0%) had a contralateral event. Of the women known not to have had radiotherapy post mastectomy, 45/2894 (1.6%) had an ipsilateral further event and 83 (2.9%) had a contralateral event. Conclusion Recurrence following mastectomy for DCIS is rare. A close (<1 mm) margin, large tumour size and microinvasion, may merit radiotherapy to reduce ipsilateral recurrence.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>26314790</pmid><doi>10.1016/j.ejso.2015.07.021</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - radiotherapy Breast Neoplasms - surgery Carcinoma, Intraductal, Noninfiltrating - diagnosis Carcinoma, Intraductal, Noninfiltrating - radiotherapy Carcinoma, Intraductal, Noninfiltrating - surgery Cohort Studies DCIS Disease-Free Survival Early Detection of Cancer Female Hematology, Oncology and Palliative Medicine Humans Mastectomy Middle Aged Neoplasm Recurrence, Local Neoplasm, Residual Prospective Studies Radiotherapy Radiotherapy, Adjuvant - methods Sloane project Surgery |
| title | Radiotherapy after mastectomy for screen-detected ductal carcinoma in situ |
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