Table 44: Lumpectomy plus radiation therapy for DCIS

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s 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.

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 also take the hormone therapy drug tamoxifen.

Radiation therapy

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
DCIS recurrence

A meta-analysis that combined the results of 4 randomized clinical trials showed lumpectomy plus radiation therapy 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 5 or more years of follow-up and meta-analyses.

Study	Study Population (number of participants)	Follow-up (years)	Percent of Women who Developed Invasive Breast Cancer*		Overall Survival (for length of follow-up)
Study	Study Population (number of participants)	Follow-up (years)	Radiation Therapy after Lumpectomy	NoRadiation 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	20	10%	14%	77%	73%
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%
Radiation Therapy Oncology Group [7]	636	7	Less than 1%	3%	92%	95%
Meta-analyses
Cochrane Collaboration [8]	2 studies		5%	11%
Stuart et al. [9]	9 studies	10	7%	11%	97%†	98%†

* Invasive breast cancer in the same breast treated for DCIS

† Breast cancer survival (not overall survival)

References

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.
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.
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.
Wärnberg F, Garmo H, Emdin S, et al. Effect of radiotherapy after breast-conserving surgery for ductal carcinoma in situ: 20 years follow-up in the randomized SweDCIS Trial. J Clin Oncol. 32:3613-18, 2014.
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.
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.
McCormick B, Winter K, Hudis C, et al. RTOG 9804: A prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation. J Clin Oncol. 33(7):709-15, 2015.
Goodwin A, Parker S, Ghersi D, Wilcken N. Post-operative radiotherapy for ductal carcinoma in situ of the breast. Cochrane Database Syst Rev. 11:CD000563, 2013.
Stuart KE, Houssami N, Taylor R, Hayen A, Boyages J. Long-term outcomes of ductal carcinoma in situ of the breast: a systematic review, meta-analysis and meta-regression analysis. BMC Cancer. 15:890, 2015.