Breast-conserving therapy for primary Ductal Carcinoma in Situ in The Netherlands: A multi-center study and population-based analysis |
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| Institution: | 1. Department of Epidemiology, Medisch Spectrum Twente, Enschede, The Netherlands;2. Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands;3. Breast Clinic Oost-Nederland, Ziekenhuis Groep Twente, Hengelo, The Netherlands;4. Institute Verbeeten, Tilburg, The Netherlands;5. Radiotherapy Institute Friesland, Leeuwarden, The Netherlands;6. Radiotherapy Institute Steden en Omstreken, Deventer, The Netherlands;7. Department of Radiation Oncology, Haaglanden Medical Centre, Leidschendam, The Netherlands;8. Departement of Research Methodology, Measurement, and Data Analysis, Faculty of Behavioural Science, University of Twente, The Netherlands;1. Department of Surgery, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA;2. Department of Public Health Sciences, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA;1. Division of Urologic Oncology, Fox Chase Cancer Center-Temple University Health System, Philadelphia, Pennsylvania;2. Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center-Temple University Health System, Philadelphia, Pennsylvania;3. Division of Medical Oncology, Fox Chase Cancer Center-Temple University Health System, Philadelphia, Pennsylvania;4. Department of Urology, Yale University, New Haven, Connecticut;5. Department of Urology, Mayo Clinic, Rochester, Minnesota;6. Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota;7. Division of Urology, State University of New York at Stony Brook, Stony Brook, New York;1. Division of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands;2. Department of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands;3. Department of Radiology, Maastricht University Medical Centre+, Maastricht, The Netherlands;4. Dutch Institute for Clinical Auditing, Leiden, The Netherlands;5. Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands;6. Division of Radiotherapy, GROW-School for Oncology and Developmental Biology (MAASTRO), Maastricht University Medical Centre+, Maastricht, The Netherlands;7. Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands;8. Department of Medical Oncology, Antoni van Leeuwenhoek Hospital–Netherlands Cancer Institute, Amsterdam, The Netherlands;9. Department of Radiotherapy, Medical Centre Haaglanden, The Hague, The Netherlands;10. Department of Research, Comprehensive Cancer Organization the Netherlands (IKNL), Utrecht, The Netherlands;11. Department of Health Technology and Services Research, MIRA Institute of Biomedical Technology and Technical Medicine, Enschede, The Netherlands;1. Department of Surgery, Wake Forest University, Winston-Salem, NC;2. Department of Surgery, Watson Clinic, Lakeland, FL;3. Department of Surgery, Thomas Jefferson University, Philadelphia, PA;4. Department of Surgery, Doctors Hospital at Renaissance, Edinburg, TX;5. Department of Surgery, Women and Infants Hospital, Providence, RI;6. Department of Surgery, University of North Carolina, Chapel Hill, NC;7. Department of Surgery Yale University, New Haven, CT;1. Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA;2. Department of Pathology, Harvard Medical School, Boston, MA, USA |
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| Abstract: | ObjectiveThe aim of this study was to analyse the efficacy of breast-conserving therapy (BCT) for women with primary DCIS in a population-based setting.MethodsData were used from five Radiotherapy centres in The Netherlands from 2000 to 2010, all treated with BCT. Of all the cases, 59.2% received a boost of radiotherapy after their whole breast irradiation (WBI), irrespective of margin status.ResultsA total of 1248 cases with primary DCIS were analysed. The 10-years LRFS was 92.9%. Age ≤50 years and a positive margin were significantly related to local relapse free survival (LRFS). Having a boost had no impact on LRFS, showing a nearly equal recurrence pattern in patients with and without a boost. Separate analyses were done on patients who had received and not received a boost of radiotherapy after WBI. We noted 9.1% contra-lateral breast tumours. The 10-years disease specific survival (DSS) rate was 99.0%.ConclusionsDCIS of the breast and treated with BCT results in excellent LRFS and DSS. Primary surgical lumpectomy with negative margins followed by WBI seems to be the treatment of choice in DCIS treated with BCS with respect to IBTR. |
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| Keywords: | Ductal carcinoma in situ Breast-conserving therapy Multi-center study Declarations of interest none |
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