To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: EBCC: Local Excision and Mastectomy Have Equal Survival Rates for Ductal Carcinoma in Situ URL: http://www.pslgroup.com/dg/243AF6.htm Doctor's Guide March 22, 2004
By Paula Moyer HAMBURG, GERMANY -- March 22, 2004 -- More than 90% of women who have ductal carcinoma in situ (DCIS) will still be living 10 years after diagnosis, regardless of whether they have mastectomy, wide local excision with radiation, or simply wide local excision, according to findings presented here March 19th at the 4th European Breast Cancer Conference. These findings give support to conservative management of DCIS, said principal investigator Dennis R. Holmes, MD, Assistant Professor of Clinical Surgery, University of Southern California's Norris Comprehensive Cancer Center and Hospital, Los Angeles, California, United States. "Our findings show that 730 mastectomies would have to be performed to have a breast cancer-specific mortality rate of zero in women with DCIS," he said. "We found that the 10-year breast cancer-specific survival rate was 100% in women who had had mastectomies, but it was 98% in women who had had wide local excision with radiation, and 97% in women who had had wide local excision alone." Dr. Holmes noted that, although local recurrence had been historically used as a marker of treatment failure in DCIS, the study's end points had gained in importance as the follow-up period for such patients has continued to lengthen. Therefore, he and his co-investigators conducted the current study to assess the rate of local recurrence, distal disease-free survival, breast cancer-specific survival and overall survival in women who had been diagnosed with DCIS. They analysed 1,136 consecutive cases from a prospective database. He noted that all recurrence and fatality data were 10-year actuarial data and that they used the Kaplan-Meier statistical method. The tumours were an average of 19 mm in the group with excision plus radiation, 16 mm in the excision monotherapy group, and 43 mm in the mastectomy group. Among these patients, 286 had undergone wide local excision with postoperative radiation, 444 had only had excision, and 406 had undergone mastectomy. Among the 1,136 patients 11.4% had recurrences, 18% in the group with excision and radiation, 30% in the excision only group, and 1.8% in the mastectomy group. Among the recurrences, 44.2% were invasive. Among those with invasive recurrence, which occurred in multiple sites in some patients, 9.1% were among those with excision and radiation, 6.1% among excision monotherapy patients, and 1.0% in mastectomy patients. The investigators documented distant metastases in 0.97% of patients. Of these, 2% occurred in the excision and radiation group, and 1.2% and 1% in the excision monotherapy group and the mastectomy group, respectively. There were eight breast cancer deaths, 2% in the excision and radiation group and 0.7% in the excision monotherapy group. The overall fatality rates were 8% for the excision plus radiation group, 8% for the excision monotherapy group, and 9% for the mastectomy group. Even for patients with invasive recurrent disease, the mortality rates were similar to those of patients with T1a or T1b node-negative primary breast cancer. Therefore, Dr. Holmes said, conservative management is a feasible strategy for DCIS. [Study title: Outcome after invasive recurrence in patients with ductal carcinoma in situ of the breast. Abstract 461] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.