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DCIS treated with excision alone using the National Comprehensive Cancer Network (NCCN) guidelines
Patricia Wehner1, Michael D Lagios, Melvin J Silverstein
1Breast Surgery, Hoag Memorial Hospital Presbyterian, University of Southern California, Los Angeles, CA, USA. tricia.wehner@gmail.com
Annals of Surgical Oncology
|August 27, 2013
Summary
Low-risk ductal carcinoma in situ (DCIS) patients meeting NCCN criteria can be safely treated with excision alone, showing a 12-year local recurrence rate of 7.8%. This approach demonstrates excellent breast cancer-specific survival.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- 2008 NCCN guidelines permit excision alone for low-risk DCIS.
- This study evaluates outcomes for DCIS patients treated solely with excision.
Purpose of the Study:
- To determine local and distant recurrence rates.
- To assess breast-cancer specific survival in DCIS patients meeting NCCN criteria and treated with excision alone.
Main Methods:
- Analysis of a prospective, single-institution database.
- Inclusion criteria: pure DCIS, tumor ≤20 mm, age ≥50, margins ≥2 mm, nuclear grade 1 or 2.
- Kaplan-Meier analysis for recurrence and survival.
Main Results:
- 205 patients treated with excision alone; median follow-up 51 months.
- 12-year local recurrence rate was 7.8%.
- 12-year breast cancer-specific survival was 100%.
Conclusions:
- Excision alone for selected low-risk DCIS patients yields favorable outcomes.
- NCCN Guidelines effectively identify patients suitable for excision alone.
- Results contrast with higher recurrence rates in NSABP Protocol B-17.
