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J Korean Soc Ther Radiol Oncol > Volume 22(1); 2004 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2004;22(1): 11-16.
Treatment Outcome and Analysis of the Prognostic Factors of Ductal Carcinoma in situ Treated with Breast Conserving Surgery and Radiotherapy
Kyoung Ju Kim, Seung Jae Huh, Won Park, Jeong Hyeon Yang, Seog Jin Nam, Jeong Han Kim, Sung Kong Lee, Jee Hyun Lee, Sung Soo Kang, Jeong Eun Lee, Min Kyu Kang, Young Je Park, Hee Rim Nam
1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sjhuh@smc.samsung.co.kr
2Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Department of Surgery, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
ABSTRACT
PURPOSE:
To evaluate the survival rate, local failure rate and patterns of failure, and analyze the prognostic factors affecting local relapse of ductal carcinoma in situ treated with breast conserving surgery and radiotherapy
Materials and Methods:
From June 1995 to December 2001, 96 patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were retrospectively analyzed. The operations were either local or wide excision in all patients, with an axillary lymph node dissection performed in some patients. Radiation dose to the whole breast was 50.4 Gy, over 5 weeks, with 1.8 Gy daily fractions, with additional doses (10~14 Gy) administered to the primary tumor bed in some patients with close (< or =2 mm) or positive resection margin. The median follow-up period was 43 months (range 12~102 months).
RESULTS:
The 5-year local relapse free survival and overall survival rates were 91 and 100% respectively. Local relapse occurred in 6 patients (6.3%). Of the 6 recurrences, one was invasive ductal cell carcinoma. With the exception of one, all patients recurred 2 years after surgery. There was no regional recurrence or distant metastasis. Five patients with local recurrence were salvaged with total mastectomy, and are alive with no evidence of disease. One patient with recurrent invasive ductal cell carcinoma will receive salvage treatment. On analysis of the prognostic factors affecting local relapse, none of the factors among the age, status of resection margin, comedo type and nuclear grade affected local relapse. Operation extent also did not affect local control (p=0.30). In the patients with close resection margin, boost irradiation to the primary tumor bed did not affect local control (p=1.0).
CONCLUSIONS:
The survival rate and local control of the patients with ductal carcinoma in situ treated with breast conserving surgery and radiotherapy were excellent. Close resection margin and boost irradiation to the primary tumor bed did not affect local relapse, but further follow-up with much more patients is needed.
Key Words: Ductal carcinoma in situ, Breast conserving surgery, Radiotherapy
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