Recurrence Rates in Ductal Carcinoma in Situ Declining Over Time

Patients with ductal carcinoma in situ (DCIS) have been experiencing a lower rate of recurrence over time, according to an abstract presented at the American Society of Clinical Oncology’s 2015 Breast Cancer Symposium in San Francisco, CA.¹

Investigators examined recurrence rates after breast-conserving surgery (BCS) for DCIS over 3 decades at one institution. It prospectively maintained a database of patients with DCIS undergoing BCS. Patients treated between 1978 and 2010 were included in the study.

Results showed that among the 2,996 cases that were observed, there was a 12% recurrence rate. Median follow-up for patients without recurrence was 75 months (range 0 to 30 years). A total of 732 patients were followed-up for 10 years or longer.

The 5-year recurrence rate for patients treated between 1978 and 1998 was 13.6% compared with 6.6% for patients treated between 1999 and 2010 (HR: 0.62; P=0.0001).

Following stratification by radiation use, and adjustment for 7 other factors, the decrease in recurrence rates was limited to those who did not receive radiation (HR: 0.62; P=0.003). There was no decline in recurrence rates among those who received radiation therapy (HR:1.13; P=.06).

Increases in screen-detection, negative margins and use of adjuvant therapy only partially explain the results. It may be due to improvements in radiologic detection and pathologic assessment. In light of the recent increase in the use of mastectomy, these results are particularly important for patient education.

Reference

1. Van Zee K, Subhedar P, Ocese C, et al. Recurrence rates for ductal carcinoma in situ: analysis of 2,996 patients treated with breast-conserving surgery over 30 years. Abstract presented at the American Society of Oncology’s 2015 Breast Cancer Symposium; September 25-27, 2015; San Francisco, CA. http://abstracts.asco.org/163/AbstView_163_155076.html. Accessed September 30, 2015.