Conservative treatment versus mastectomy for breast ductal carcinoma in situ: outcomes and quality of life

IF 0.2 Q4 OBSTETRICS & GYNECOLOGY

Revista de Senologia y Patologia Mamaria Pub Date : 2024-07-14 DOI:10.1016/j.senol.2024.100611

Beatriz Gil Haro , Cristina de la Fuente Alonso , Sofía Córdoba Largo , Joaquín Velasco Jiménez , Marta López Valcárcel , Raquel Benlloch Rodríguez , María Esther Ramírez Medina , Mariano Artés Casellés , Cesáreo Corbacho Cuevas , María Carmen Vega Carrasco , José Ramón Castelló Fortet , Irma Zapata Paz , María Hernández Miguel , Sofía Santana Jiménez , María Isabel García Berrocal , Jaime Ricardo Gómez Jaramillo , Francisco Javier Martínez Paredes , Sara Pérez Mata , Jesús Romero Fernández

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Abstract

Introduction

Ductal carcinoma in situ (DCIS) accounts for 20% of new breast cancer diagnoses. Treatment includes breast-conserving surgery (BCS) with or without radiation therapy (RT), mastectomy, and sentinel lymph node biopsy. Surgical decisions depend on the centre's policy and patient choice. We aimed to compare outcomes and quality-of-life (QoL) between treatment with BCS + RT or mastectomy in patients with breast DCIS.

Methods

We conducted a retrospective study of 155 patients with DCIS from January 2009 to December 2018. Among them, 83 were treated with mastectomy and 72 with BCS + RT. Disease-free survival (DFS), local-recurrence-free survival, and overall survival (OS) were recorded. Statistics: Kaplan–Meier, log rank.

Results

Median follow-up was 82 months (33–152). Five- and 10-year DFS were 93% and 91%, respectively. There were no differences in DFS rate between the 2 groups (9.6% vs 6.9%, p = .38). OS rates at 5- and 10-years was 100% in both groups. Larger tumours were associated with a higher contralateral DCIS relapse (47.3 mm vs 19.3 mm, p = .004). In mastectomy group, patients with tumour size > 2 cm had a worse 5- and 10-years DFS than patients with smaller tumours (p = .019). In terms of QoL, there was no difference between the 2 treatment groups.

Conclusion

BCS + RT and mastectomy offer similar clinical outcomes and QoL. Our results demonstrate that BCS is a viable option even for patients with larger tumours. These findings serve as a guide for clinical decision-making to optimise the management of DCIS.

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乳腺导管原位癌的保守治疗与乳房切除术：疗效与生活质量

导言导管原位癌（DCIS）占乳腺癌新诊断病例的 20%。治疗方法包括接受或不接受放射治疗（RT）的保乳手术（BCS）、乳房切除术和前哨淋巴结活检。手术决定取决于中心的政策和患者的选择。我们旨在比较乳腺 DCIS 患者接受 BCS + RT 或乳房切除术治疗的结果和生活质量（QoL）。方法我们对 2009 年 1 月至 2018 年 12 月期间的 155 例 DCIS 患者进行了回顾性研究。其中，83人接受了乳房切除术，72人接受了BCS+RT治疗。记录了无病生存期（DFS）、无局部复发生存期和总生存期（OS）。统计数据：结果中位随访时间为 82 个月（33-152 个月）。5年和10年的DFS分别为93%和91%。两组的 DFS 率无差异（9.6% vs 6.9%，P = .38）。两组患者5年和10年的OS率均为100%。肿瘤越大，对侧DCIS复发率越高（47.3 mm vs 19.3 mm，p = .004）。在乳房切除术组中，肿瘤大小为 2 厘米的患者的 5 年和 10 年 DFS 比肿瘤较小的患者差（p = .019）。结论 BCS + RT 和乳房切除术的临床疗效和 QoL 相似。我们的研究结果表明，即使肿瘤较大的患者也可以选择 BCS。这些研究结果为临床决策提供了指导，以优化 DCIS 的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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