Breast conservative surgery for well-differentiated ductal intraepithelial neoplasia: Risk factors for ipsilateral breast tumor recurrence

Breast. 2014 Dec;23(6):829-35. doi: 10.1016/j.breast.2014.08.016. Epub 2014 Sep 26.

Abstract

Rational: We retrospectively analyzed 232 patients affected by well differentiated ductal intraepithelial neoplasia (DIN1c or DCIS G1) treated with conservative surgery without adjuvant radiotherapy.

Results: 25 invasive and 18 non-invasive local recurrences were observed (median follow-up 80 months; 5-year cumulative incidence: 12.2%). Seven of the 15 young patients (<40 y) developed local recurrence (2 in situ, 5 invasive). Age <50 (HR 1.89, 95% C.I. 1.01-3.45), multifocality (HR 3.21, 95% C.I. 1.46-7.06), Ki-67 > 7% (HR 2.33, 95% C.I. 1.20-4.55) and surgical margins <10 mm (HR 2.00, 95% C.I. 1.06-3.76) were significantly associated with an increased risk of local recurrence.

Conclusions: Young age, multifocality and small margins appeared as clear risk factors of local recurrence in DIN1c (DCIS G1) population. The presence of multiple poor prognostic features warrant a thorough discussion regarding local treatment.

Keywords: Breast cancer; DCIS; DIN; Ductal carcinoma in situ; Radiation therapy.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Carcinoma, Ductal, Breast*
  • Carcinoma, Intraductal, Noninfiltrating / metabolism
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Carcinoma, Intraductal, Noninfiltrating / surgery*
  • Cohort Studies
  • Female
  • Humans
  • Mastectomy, Segmental*
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Recurrence, Local*
  • Neoplasms, Multiple Primary / metabolism
  • Neoplasms, Multiple Primary / pathology
  • Neoplasms, Multiple Primary / surgery*
  • Prognosis
  • Receptor, ErbB-2 / metabolism
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism
  • Retrospective Studies
  • Risk Factors

Substances

  • Receptors, Estrogen
  • Receptors, Progesterone
  • ERBB2 protein, human
  • Receptor, ErbB-2