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Recurrence outcomes after omission of postoperative radiotherapy following breast-conserving surgery for ductal carcinoma in situ of the breast: a multicenter, retrospective study in Korea (KROG 16-02)

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Abstract

Purpose

To evaluate the loco-regional recurrence (LRR) rate after breast-conserving surgery without postoperative radiotherapy (RT) for ductal carcinoma in situ (DCIS) of the breast.

Methods

Between 2000 and 2010, 311 DCIS patients from 9 institutions were analyzed retrospectively. The median age was 47 (range, 20–82). The median tumor size was 7 mm (range, 0.01–76). Margin width was <1 cm in 85 patients (27.3%), and nuclear grade was high in 37 patients (11.9%). Two hundred and three patients (65.3%) received tamoxifen.

Results

With a median follow-up of 74 months (range, 5–189), there were 11 local recurrences (invasive carcinoma in 6 and DCIS in 5) and 1 regional recurrence. The 7-year LRR rate was 3.8%. On univariate analysis, age and margin width were significant risk factors influencing LRR (p = 0.017 and 0.014, respectively). When age and margin width were combined among 211 patients whose margin width were available, the 7-year LRR rates were as follows (p < 0.001): (1) 0% in patients with age >50 years and any margin width status (n = 64), (2) 1.2% in age ≤50 years and margin width ≥1 cm (n = 93), (3) 13.1% in age ≤50 years and margin width <1 cm (n = 54).

Conclusions

The LRR rate was very low in selected DCIS patients treated with breast-conserving surgery without postoperative RT. However, adjuvant RT should be considered for those with age ≤50 years and margin width <1 cm.

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Author notes

    Authors and Affiliations

    1. Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Republic of Korea

      Kyubo Kim & Yi-Jun Kim

    2. Center for Breast Cancer, National Cancer Center, Goyang, Gyeonggi, Republic of Korea

      So-Youn Jung

    3. Department of Radiation Oncology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea

      Kyung Hwan Shin, Jin Ho Kim, In Ah Kim & Suzy Kim

    4. Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea

      Wonshik Han & Han-Byoel Lee

    5. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

      Seung Jae Huh, Doo Ho Choi & Won Park

    6. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

      Seung Do Ahn & Su Ssan Kim

    7. Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea

      Jin Hee Kim

    8. Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea

      Chang-Ok Suh & Yong Bae Kim

    9. Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea

      In Ah Kim

    10. Department of Radiation Oncology, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea

      Suzy Kim

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    1. Kyubo Kim
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    Correspondence to Kyung Hwan Shin.

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    The authors declare that they have no conflict of interest.

    Ethical Approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Additional information

    Kyubo Kim and So-Youn Jung have contributed equally to this work.

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    Kim, K., Jung, SY., Shin, K.H. et al. Recurrence outcomes after omission of postoperative radiotherapy following breast-conserving surgery for ductal carcinoma in situ of the breast: a multicenter, retrospective study in Korea (KROG 16-02). Breast Cancer Res Treat 162, 77–83 (2017). https://doi.org/10.1007/s10549-017-4111-1

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