> Table 45: 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.
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Introduction: Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer that begins in the milk ducts. Without treatment, DCIS can progress to invasive breast cancer over time. Because health care providers cannot predict which cases of DCIS will progress to invasive cancer and which will not, every case of DCIS is treated.
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 found 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
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Study Population
(number of participants)
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Follow-up
(years)
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Percent of Women who Developed
Invasive Breast Cancer*
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Overall Survival
(for length of follow-up)
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Radiation Therapy
after Lumpectomy
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No Radiation Therapy
after Lumpectomy
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Radiation Therapy
after Lumpectomy
|
No Radiation Therapy
after Lumpectomy
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Randomized clinical trials
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UK, Australia, New Zealand (UK/ANZ) DCIS Trial [3]
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1,694
|
12.7
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3.6%
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9.2%
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88.2%
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90.1%
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Swedish Breast Cancer Group [4]
|
1,046
|
8.4
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7.2%
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12.3%
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91.6%
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90.4%
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European Organization for Research and Treatment of Cancer (EORTC) [5]
|
1,010
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10.5
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8%
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13%
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95%
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95%
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National Surgical Adjuvant Breast and Bowel Project (NSABP) B-17 [6]
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813
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17.3
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8.9%
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19.4%
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82.9%
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84.2%
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* Invasive breast cancer in the same breast with 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. Bijker N, Meijnen P, Peterse JL, et al. for the EORTC Breast Cancer Cooperative Group and the EORTC Radiotherapy Group. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phase III trial 10853—a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. J Clin Oncol. 24(21):3381-7, 2006.
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 01/19/12
