Young age is not associated with increased local recurrence for DCIS treated by breast-conserving surgery and radiation

J Surg Oncol. 2009 Jul 1;100(1):25-31. doi: 10.1002/jso.21284.


Background: We report local recurrence (LR) after breast-conserving surgery and radiation (BCS + RT) for ductal carcinoma in situ (DCIS) to determine outcomes for patients aged <or=40 years compared with older women.

Methods: The study included 440 women with DCIS treated from 1978 to 2007. All patients received whole-breast radiotherapy with a boost in 95% of cases. Demographics, characteristics, surgical, and adjuvant treatments were analyzed for an effect on LR.

Results: Median age was 56.5 years with 24 patients aged <or=40. Median DCIS size was 0.8 cm. Re-excision was required in 62% of patients, and in 75% of those aged <or=40. Tamoxifen was used in 22%, but only one patient aged <or=40. Median follow-up was 6.8 years. Actuarial LR was 7% (95% confidence interval of 4-11%) at 10 years and 8% (5-14%) at 15 years. There was no difference in LR by age (P = 0.76).

Conclusions: The long-term risk of LR after BCS + RT for DCIS is low, even in patients <or=40 years. This may be due to patient selection for small size, high utilization of re-excision, and radiation boost. Young age may be a smaller contributor to LR risk in DCIS than previously suggested.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / therapy*
  • Carcinoma in Situ / therapy*
  • Carcinoma, Ductal, Breast / therapy*
  • Combined Modality Therapy
  • Female
  • Humans
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Recurrence, Local / etiology*