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Invasive Local Recurrence in DCIS Can Turn ‘Indolent’ Disease Into Life-Threatening Condition

Invasive Local Recurrence in DCIS Can Turn ‘Indolent’ Disease Into Life-Threatening Condition

REIMS, France—Results of a French study suggest that oncologists should not
underestimate the potential threat posed by local recurrence of ductal
carcinoma in situ (DCIS). Reporting on the DCIS experience of 11 French cancer
centers, Bruno Cutuli, MD, a radiation oncologist at the Center for
Radiotherapy and Oncology at Polyclinique Courlancy in Reims, France,
emphasized the importance of optimal initial treatment, close follow-up and
definitive treatment after an invasive local recurrence.

The study population was 1,521 patients treated for pure DCIS between 1985
and 1996, Dr. Cutuli said. The median age of the group was 53. Initial DCIS
treatment was mastectomy (306 patients), conservative surgery alone (403
patients), and conservative surgery plus radiotherapy (812 patients).

The median follow-up for the group was 83 months. The median follow-up after
local recurrence was 44 months.

Recurrence Rate by Treatment

A total of 213 patients experienced a local recurrence. Of these, 90 had in
situ lesions, and 123 had invasive tumors. The local recurrence rate was 1.6%
after mastectomy (5 of 306 patients), 26.1% after conservative surgery alone
(105 of 403 patients), and 12.6% after conservative surgery plus radiotherapy
(103 of 812 patients).

Among patients treated with mastectomy, the median time to local recurrence
was 55 months. All five recurrences were invasive cancers. One patient had a
nodal recurrence, and two patients had metastases and subsequently died.

In the conservative surgery-alone group, the median time to recurrence was
37 months, and 82% of the recurrences occurred in less than 5 years. The types
of recurrence were: in situ (52 patients), invasive (53 patients), nodal (9
patients), and distant metastasis (5 patients).


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