Breast-conserving therapy of ductal carcinoma in situ: frequency of local recurrence after wide excision with and without additional radiotherapy, a retrospective study of 42 cases.

Clinicopathologic features were retrospectively studied in 42 patients with ductal carcinoma in situ (DCIS), who underwent breast-conserving therapy at the Netherlands Cancer Institute from 1974 to 1987. During follow-up (13 to 128 months, average 73 months) five of the 14 patients treated with an excision alone recurred locally. Recurrence occurred in only one out of 28 patients who received additional radiotherapy. Secondary mastectomy was performed in five patients with recurrence, all are alive with no evidence of disease (average follow-up 21 months). One patient developed disseminated disease. Breast-conserving therapy might be considered in selected cases of DCIS with a limited extent, when a complete excision can be accomplished. Additional radiotherapy may reduce the risk of recurrence. Because most series in literature are small, retrospective, selected and with a short follow-up randomized prospective trials have to demonstrate what subset of patients with DCIS can safely be treated with breast-conserving therapy. Therefore, participation in these studies, is of the utmost importance.