Ahmet Serkan Ilgun1, Gul Alco2, Alper Ozturk3, Filiz Celebi4, Zeynep Erdogan5, Cetin Ordu6, Fatma Aktepe7, Gursel Soybir8, Vahit Ozmen9
1Department of Surgery, Demiroglu Bilim University, Istanbul, Turkey.
2Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey.
3Department of Surgery, Biruni University Medical School, Istanbul, Turkey.
4Department of Radiology, Yeditepe University Medical School, Istanbul, Turkey.
5Physical Therapy and Rehabilitation Center, Medical Park Göztepe Hospital, Istanbul, Turkey.
6Department of Medicine, Division of Medical Oncology, Demiroglu Bilim University, Istanbul, Turkey.
7Department of Pathology, Sisli Memorial Hospital, Istanbul, Turkey.
8Department of Surgery, Sisli Memorial Hospital, Istanbul, Turkey.
9Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Summary
Purpose: This retrospective analysis aimed to investigate factors related to local recurrence and the effects of additional radiotherapy (RT) boost after whole breast radiation therapy (WBRT) on local recurrence in patients with ductal carcinoma in situ (DCIS) undergoing breast-conserving surgery (BCS).
Methods: A total of 197 patients treated for DCIS between 1998 and 2018 were retrospectively evaluated. Patients with microinvasion, intracystic in situ cancer, those undergoing mastectomy, less than 12 months of follow-up, and those with missing information were excluded from the analysis.
Results: The median age of the patients was 50 years (range: 28-78), and the median follow-up time was 97 months (range: 12-257). Local recurrence occurred in eight patients (4%), with six being invasive and two being DCIS. Boost radiation was administered to 143 patients (72.6%). The study found no significant difference in local recurrence-free survival between patients who received boost radiation and those who did not (p=0.94). Factors significantly associated with local recurrence were age, tumor diameter, and surgical margin width (≤2 mm) in univariate analysis, while only tumor diameter and surgical margin width (≤2 mm) remained significant in multivariate analysis.
Conclusion: Surgical margin width and tumor diameter were independently associated with local recurrence in DCIS patients undergoing BCS. However, patient age, RT boost, hormonotherapy use, and poor histological features did not show significant associations with local recurrence.
Keywords: breast cancer, breast-conserving surgery, boost, ductal carcinoma in situ, local recurrence, radiotherapy
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