Re-excision in Ductal Carcinoma In Situ Is Not Associated With Improved Local Control: A Retrospective Cohort Study

Area of Science:

• Oncology
• Breast Cancer Research
• Surgical Oncology

Background:

• Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer precursor.
• Surgical excision is the primary treatment for DCIS.
• The role of re-excision in achieving clear margins and its effect on local recurrence are debated.

Purpose of the Study:

• To evaluate the impact of re-excision on the risk of ipsilateral breast tumor recurrence in patients with DCIS.
• To identify factors influencing local recurrence in DCIS patients.
• To clarify the controversial role of re-excision in DCIS management.

Main Methods:

• Retrospective single-center cohort study of DCIS patients (2003-2015).
• Analysis of clinical and pathological parameters including age, menopausal status, tumor size, nuclear grade, re-excision, and adjuvant radiotherapy.
• Log-rank testing and multivariate Cox regression for recurrence risk analysis, with data from the German cancer registry.

Main Results:

• Out of 247 patients with follow-up data, 119 (48.2%) underwent re-excision.
• The 5-year local recurrence rate was 2.9% with re-excision versus 6.0% without (P = .33).
• Younger age and premenopausal status were significant risk factors for recurrence; adjuvant radiotherapy demonstrated a protective effect.

Conclusions:

• Re-excision was not significantly associated with a different risk of local recurrence in DCIS patients.
• Younger age and premenopausal status are independent risk factors for local recurrence.
• Adjuvant radiotherapy is associated with improved local control in DCIS management.