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Home > Understanding Breast Cancer > Breast Cancer Research > Table 44: Lumpectomy plus radiation therapy in the treatment of DCIS

  


Table 44: Lumpectomy plus radiation therapy in the treatment of DCIS

  

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer. “In situ” means "in place." In DCIS, the abnormal cells are contained in the milk ducts, but have not invaded nearby breast tissue. Without treatment, DCIS can progress to invasive breast cancer over time, so all cases of DCIS are treated. Treatment involves surgery, with or without radiation therapy. Some women may take tamoxifen (learn more).  

Radiation therapy in the treatment of DCIS

Radiation therapy is not given to women who are treated with mastectomy for DCIS.

Lumpectomy for DCIS is usually followed by radiation therapy to lower the risk of invasive breast cancer and DCIS recurrence. A meta-analysis that combined the results of four randomized clinical trials showed lumpectomy plus radiation lowered the risk of invasive breast cancer after DCIS (in the same breast as the DCIS) by 50 percent compared to lumpectomy alone [1]. Overall survival appears similar for women with DCIS who have lumpectomy with or without radiation therapy [1-2].

Learn more about treatment for DCIS.

Learn about the strengths and weaknesses of different types of studies.

Study selection criteria: Randomized clinical trials with at least 500 participants and five or more years of follow-up.  

 Study 

 Study Population
(number of participants)
 

 Follow-up
(years)
 

 Percent of Women who Developed
Invasive Breast Cancer*
 

Overall Survival
(for length of follow-up)
 

 Radiation Therapy
after Lumpectomy
 

 No Radiation Therapy
after Lumpectomy
 

 Radiation Therapy
after Lumpectomy
 

No Radiation
Therapy
after Lumpectomy
 

Randomized clinical trials 

UK, Australia, New Zealand (UK/ANZ) DCIS Trial [3]

1,694

13

4%

9%

88%

90%

Swedish Breast Cancer Group [4]

1,046

8

7%

12%

92%

90%

European Organization for Research and Treatment of Cancer (EORTC) [5]

1,010

16

9%

15%

90%

88%

National Surgical Adjuvant Breast and Bowel Project (NSABP) B-17 [6]

813

17

9%

19%

83%

84%

 * Invasive breast cancer in the same breast treated for DCIS.


References  

1. Goodwin A, Parker S, Ghersi D, Wilcken N. Post-operative radiotherapy for ductal carcinoma in situ of the breast. Cochrane Database Syst Rev. (4):CD000563, 2009.

2. Correa C, McGale P, Taylor C, et al. for the Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast. J Natl Cancer Inst Monogr. 2010(41):162-77, 2010.

3. Cuzick J, Sestak I, Pinder SE, et al. Effect of tamoxifen and radiotherapy in women with locally excised ductal carcinoma in situ: long-term results from the UK/ANZ DCIS trial. Lancet Oncol. 12(1):21-9, 2011.

4. Holmberg L, Garmo H, Granstrand B, et al. Absolute risk reductions for local recurrence after postoperative radiotherapy after sector resection for ductal carcinoma in situ of the breast. J Clin Oncol. 26(8):1247-52, 2008.

5. Donker M, Litière S, Werutsky G, et al. Breast-conserving treatment with or without radiotherapy in ductal carcinoma in situ: 15-year recurrence rates and outcome after a recurrence, from the EORTC 10853 randomized phase III trial. J Clin Oncol. 31(32):4054-9, 2013.

6. Wapnir IL, Dignam JJ, Fisher B, et al. Long-term outcomes of invasive ipsilateral breast tumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS. J Natl Cancer Inst. 103(6):478-88, 2011.

Updated 01/13/14