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
{"title":"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","authors":"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","doi":"10.1016/j.senol.2024.100611","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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%, <em>p</em> <!-->=<!--> <!-->.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, <em>p</em> <!-->=<!--> <!-->.004). In mastectomy group, patients with tumour size ><!--> <!-->2 cm had a worse 5- and 10-years DFS than patients with smaller tumours (<em>p</em> <!-->=<!--> <!-->.019). In terms of QoL, there was no difference between the 2 treatment groups.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 4","pages":"Article 100611"},"PeriodicalIF":0.2000,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Conservative treatment versus mastectomy for breast ductal carcinoma in situ: outcomes and quality of life\",\"authors\":\"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\",\"doi\":\"10.1016/j.senol.2024.100611\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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%, <em>p</em> <!-->=<!--> <!-->.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, <em>p</em> <!-->=<!--> <!-->.004). In mastectomy group, patients with tumour size ><!--> <!-->2 cm had a worse 5- and 10-years DFS than patients with smaller tumours (<em>p</em> <!-->=<!--> <!-->.019). In terms of QoL, there was no difference between the 2 treatment groups.</p></div><div><h3>Conclusion</h3><p>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.</p></div>\",\"PeriodicalId\":38058,\"journal\":{\"name\":\"Revista de Senologia y Patologia Mamaria\",\"volume\":\"37 4\",\"pages\":\"Article 100611\"},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2024-07-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista de Senologia y Patologia Mamaria\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0214158224000392\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista de Senologia y Patologia Mamaria","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0214158224000392","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Conservative treatment versus mastectomy for breast ductal carcinoma in situ: outcomes and quality of life
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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