Journal
CANCER CONTROL
Volume 28, Issue -, Pages -Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/1073274821997426
Keywords
DCIS; radiotherapy; mastectomy; breast-conservation surgery; tumor grade; local recurrence
Categories
Funding
- National Science and Technology Major Project [2020ZX09201021]
- Medical Artificial Intelligence Project of Sun Yat-Sen Memorial Hospital [YXRGZN201902]
- National Natural Science Foundation of China [81572596, 81972471, U1601223]
- Natural Science Foundation of Guangdong Province [2017A030313828]
- Guangzhou Science and Technology Major Program [201704020131]
- Guangdong Science and Technology Department [2017B030314026]
- Sun Yat-Sen University Clinical Research 5010 Program [2018007]
- Sun Yat-Sen Clinical Research Cultivating Program [SYS-C-201801]
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This study compared survival rates between mastectomy and BCS plus adjuvant radiotherapy in patients with DCIS, finding no significant difference in local recurrence and disease-free survival rates between the two groups. Factors such as tumor grade and age were significantly associated with LRFS and DFS rates, with mastectomy potentially offering better outcomes in patients with grade III tumors.
Purpose: Although breast conservation surgery(BCS) followed by adjuvant radiotherapy is now the mainstream treatment method for breast ductal carcinoma in situ(DCIS), mastectomy is still performed in some patients who refuse to undergo radiation. However, the most effective treatment method for these patients is still unknown. In the current study, we aimed to compare the survival rates between mastectomy and BCS plus adjuvant radiotherapy in patients with DCIS. Materials and Methods: We performed a retrospective study of 333 patients with DCIS from May 2004 to December 2016. There were 209 patents who were treated with BCS and adjuvant radiotherapy, while the remaining of 124 patients underwent mastectomy. The disease-free survival (DFS) and local recurrence-free survival(LRFS) rates were compared between the 2 treatment groups. Cox proportional hazards regression was performed to explore factors associated with DFS and LRFS. Results: The 10-year local recurrence(LR) rates in the mastectomy and BCS plus adjuvant radiotherapy groups were 2.6% and 7.5%, respectively. There was no difference in the LR rate between the 2 groups. Furthermore the DFS rate was also similar between the mastectomy and BCS plus adjuvant radiotherapy groups. Based on the multivariable analysis, age and tumor grade were significantly correlated with the LRFS and DFS rates. In the subgroup analysis based on the factors of age and tumor grade, patients with a tumor grade of III who underwent mastectomy had better LRFS and DFS rates compared to those who received BCS plus radiotherapy. Conclusion: In patients with DCIS, the long-term efficacy was similar between mastectomy and BCS followed by adjuvant radiotherapy. However, in the subgroup of patients with grade III tumors, mastectomy seems to offer a better LRFS and DFS than BCS plus radiotherapy.
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