{"id":3553,"date":"2017-08-03T00:00:00","date_gmt":"2017-08-03T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/omitting-radiation-therapy-after-lumpectomy-for-pure-dcis-does-not-reduce-the-risk-of-salvage-mastectomy\/"},"modified":"2023-06-14T19:22:42","modified_gmt":"2023-06-14T23:22:42","slug":"omitting-radiation-therapy-after-lumpectomy-for-pure-dcis-does-not-reduce-the-risk-of-salvage-mastectomy","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/omitting-radiation-therapy-after-lumpectomy-for-pure-dcis-does-not-reduce-the-risk-of-salvage-mastectomy\/","title":{"rendered":"Omitting radiation therapy after lumpectomy for pure DCIS does not reduce the risk of salvage mastectomy"},"content":{"rendered":"<p><strong>Purpose <\/strong>&#x2014; Radiation therapy (RT) after breast-conserving surgery (BCS) for Ductal Carcinoma in Situ (DCIS) halves the risk of local recurrence (LR). The omission of RT is often supported by the paradigm that patients who develop LR can be salvaged with further breast-conserving therapy leading to higher rates of breast preservation and improved quality of life. However, population-based, long-term rates of breast preservation in women treated by upfront BCS &#xb1; RT are unknown.<\/p>\n<p><span class=\"bold\">Methods and Materials<\/span> &#x2014; Women diagnosed with pure DCIS from 1994 to 2003 treated with BCS &#xb1; RT in Ontario were identified. Median follow-up is 12 years. The development and treatment of LR and contralateral breast cancers were determined by administrative databases with validation. The 10-year mastectomy-free survival was calculated using the Kaplan-Meier method. The impact of RT on breast preservation was determined by propensity-adjusted cox proportional hazards model.<\/p>\n<p><strong>Results <\/strong>&#x2014; The cohort includes 3303 women with DCIS; 1649 (50%) underwent BCS alone, 1654 (50%) underwent BCS + RT. Women treated by BCS alone were more likely to develop a LR compared to those treated by upfront BCS + RT (20.8% versus 15.5%, p &lt; 0.001). Mastectomy was used to treat LR in 57.4% (197\/343) of women who recurred after BCS alone and 67.6% (174\/257) of those who recurred after BCS + RT. Women treated with upfront BCS + RT had higher rates of bilateral breast preservation at 10 years compared to those treated by BCS alone (87.3% vs.82.7%, p = 0.0096).<\/p>\n<p><strong>Conclusion <\/strong>&#x2014; Local Recurrence after BCS alone does not favor breast preservation.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Purpose &#x2014; Radiation therapy (RT) after breast-conserving surgery (BCS) for Ductal Carcinoma in Situ (DCIS) halves the risk of local recurrence (LR). The omission of RT is often supported by the paradigm that patients who develop LR can be salvaged with further breast-conserving therapy leading to higher rates of breast preservation and improved quality of [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-3553","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Rakovitch E, Nofech-Mozes S, Hanna W, Sutradhar R, Gu S, Fong C, Tuck A, Youngson B, Miller N, Done SJ, Chang MC, Sengupta S, Elavathil L, Jani PA, Bonin M, Lalani N, Paszat L. <em>Breast<\/em>. 2018; 37:181-6. Epub 2017 Aug 3.","source_url":"https:\/\/doi.org\/10.1016\/j.breast.2017.07.002","ices_scientist":[1341,1370,1099],"site":[6733],"research_program":[6741],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"C2E6EC16-94C7-4210-93AD-140F14330FD7","sitecore_item_name":"Omitting-radiation-therapy-after-lumpectomy-for-pure-DCIS-does-not-reduce-the-risk","sitecore_field_values":"{\n  \"Title\": \"Omitting radiation therapy after lumpectomy for pure DCIS does not reduce the risk of salvage mastectomy\",\n  \"Short title\": \"Omitting radiation therapy\",\n  \"Summary\": \"This study looked at radiation therapy after breast-conserving surgery for Ductal Carcinoma in Situ.\",\n  \"Citation\": \"<p>Rakovitch E, Nofech-Mozes S, Hanna W, Sutradhar R, Gu S, Fong C, Tuck A, Youngson B, Miller N, Done SJ, Chang MC, Sengupta S, Elavathil L, Jani PA, Bonin M, Lalani N, Paszat L. <em>Breast<\/em>. 2018; 37:181-6. Epub 2017 Aug 3.<\/p>\",\n  \"Abstract\": \"<p><strong>Purpose <\/strong>&mdash; Radiation therapy (RT) after breast-conserving surgery (BCS) for Ductal Carcinoma in Situ (DCIS) halves the risk of local recurrence (LR). The omission of RT is often supported by the paradigm that patients who develop LR can be salvaged with further breast-conserving therapy leading to higher rates of breast preservation and improved quality of life. However, population-based, long-term rates of breast preservation in women treated by upfront BCS &plusmn; RT are unknown.<\/p>n<p><span class=\"bold\">Methods and Materials<\/span> &mdash; Women diagnosed with pure DCIS from 1994 to 2003 treated with BCS &plusmn; RT in Ontario were identified. Median follow-up is 12 years. The development and treatment of LR and contralateral breast cancers were determined by administrative databases with validation. The 10-year mastectomy-free survival was calculated using the Kaplan-Meier method. The impact of RT on breast preservation was determined by propensity-adjusted cox proportional hazards model.<\/p>n<p><strong>Results <\/strong>&mdash; The cohort includes 3303 women with DCIS; 1649 (50%) underwent BCS alone, 1654 (50%) underwent BCS + RT. Women treated by BCS alone were more likely to develop a LR compared to those treated by upfront BCS + RT (20.8% versus 15.5%, p &lt; 0.001). Mastectomy was used to treat LR in 57.4% (197\/343) of women who recurred after BCS alone and 67.6% (174\/257) of those who recurred after BCS + RT. Women treated with upfront BCS + RT had higher rates of bilateral breast preservation at 10 years compared to those treated by BCS alone (87.3% vs.82.7%, p = 0.0096).<\/p>n<p><strong>Conclusion <\/strong>&mdash; Local Recurrence after BCS alone does not favor breast preservation.<\/p>n<p><a href=\"https:\/\/doi.org\/10.1016\/j.breast.2017.07.002\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{85DE96A6-4C96-40C7-8E6D-7597A0EB5F80}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{CFFF9366-6EFD-41AF-8E1E-5C38A65A0CE9}|{56BF24FA-D81E-4114-BF1F-4715A424E26C}|{F137150D-7BD5-4368-8FCC-FAF6D82891C4}\",\n  \"Posted Date\": \"20170803T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2017\/August\/Omitting-radiation-therapy-after-lumpectomy-for-pure-DCIS-does-not-reduce-the-risk"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Omitting radiation therapy after lumpectomy for pure DCIS does not reduce the risk of salvage mastectomy<\/title>\n<meta name=\"description\" content=\"Purpose &#x2014; Radiation therapy (RT) after breast-conserving surgery (BCS) for Ductal Carcinoma in Situ (DCIS) halves the risk of local recurrence\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/omitting-radiation-therapy-after-lumpectomy-for-pure-dcis-does-not-reduce-the-risk-of-salvage-mastectomy\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Omitting radiation therapy after lumpectomy for pure DCIS does not reduce the risk of salvage mastectomy\" \/>\n<meta property=\"og:description\" content=\"Purpose &#x2014; Radiation therapy (RT) after breast-conserving surgery (BCS) for Ductal Carcinoma in Situ (DCIS) halves the risk of local recurrence\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/omitting-radiation-therapy-after-lumpectomy-for-pure-dcis-does-not-reduce-the-risk-of-salvage-mastectomy\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:22:42+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/omitting-radiation-therapy-after-lumpectomy-for-pure-dcis-does-not-reduce-the-risk-of-salvage-mastectomy\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/omitting-radiation-therapy-after-lumpectomy-for-pure-dcis-does-not-reduce-the-risk-of-salvage-mastectomy\\\/\",\"name\":\"ICES | Omitting radiation therapy after lumpectomy for pure DCIS does not reduce the risk of salvage mastectomy\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2017-08-03T04:00:00+00:00\",\"dateModified\":\"2023-06-14T23:22:42+00:00\",\"description\":\"Purpose &#x2014; 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