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Check Margins, Wait for Breast Reconstruction in Younger Women With DCIS: Presented at ACS

By Roberta Friedman, PhD

SAN FRANCISCO -- October 17, 2008 -- Women with ductal carcinoma in situ (DCIS) benefit from breast reduction techniques applied by plastic surgeons but may need to have a new operation if the margins turn out to be positive for malignancy.

Data from a series of patients were presented here on October 15 at the American College of Surgeons (ACS) 94th Annual Clinical Congress.

Hanjoon Mike Song, MD, Emory School of Medicine, Atlanta, Georgia, noted that DCIS now makes up 20% of all breast cancers. Predicting the probability of recurrence may depend critically on the surgical margins, which can affect decisions about reconstructing the breast.

Dr. Song reported on all 28 women who had lumpectomies for DCIS at his institution from 1991 to 2006, who were confirmed by biopsy, and who had simultaneous reduction mammoplasty or mastoplexy. The average age of the women was 47 years. Ten required reoperation. All who had additional surgery had intermediate- or high-grade comedo-type DCIS.

The women who had additional surgery were "a decade younger," Dr. Song said, at an average of 45.6 years old compared with 57.8 years old for women who did not require additional surgery (P < .05).

Biopsy weight and type of excision were similar in the 2 groups, as were tumour location, surgery type, and complications.

"We need to balance cosmetics with the need for cancer treatment," said Dr. Song, noting that the women who required additional breast surgeries tended to be younger and to have more aggressive tumours. "Stricter patient selection will minimise the need for reoperation."

He said that, at his institution, all women with DCIS will get radiation therapy postoperatively.


[Presentation title: The Use of Oncoplastic Reduction Techniques to Reconstruct Partial Mastectomy Defects in Women With Ductal Carcinoma in Situ.]

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