Oncoplastic breast surgery for the management of ductal carcinoma in situ (DCIS): is it oncologically safe? A retrospective cohort analysis

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Abstract

Background: Few data exist in literature regarding oncoplastic surgery (ONC) and ductal carcinoma in situ (DCIS). The role of ONC in the treatment of DCIS has not been elucidated yet: no case-control study has yet been published on the issue and no long-term oncologic results are reported. Methods: Using the European Institute of Oncology (IEO) institutional breast cancer data base we investigated the oncologic safety of ONC for DCIS comparing a consecutive series of 44 patients who have underwent ONC followed by external irradiation for DCIS (Group A-study group) with 375 patients who received conservation alone followed by external irradiation for DCIS (Group B– control group) in the same period. We excluded patients presenting with secondary tumors or local relapses and those requiring re-excision or completion mastectomy for positive margins. Primary endpoints were disease-free survival (DFS) and ipsilateral breast tumor recurrence (IBTR) within the study group and comparison with the control group. Results: Events rates and death rates were similar in the two groups. The average annual rate of invasive IBTR in group A and B was 1.6% and 1.0% respectively. No difference in the rate of lymphnode metastasis, distant metastasis, contralateral breast cancer, other primary cancer or death was observed across the two groups. Conclusions: Our findings suggest the safety of ONC and irradiation for the management of DCIS extending the indications for conservation in DCIS patients otherwise treated with mastectomy. It provides the best available evidence supporting ONC as a valid treatment option for the management of DCIS.

Original languageEnglish
Pages (from-to)957-962
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume44
Issue number7
DOIs
Publication statusPublished - Jul 1 2018

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Carcinoma, Intraductal, Noninfiltrating
Breast
Cohort Studies
Breast Neoplasms
Mastectomy
Recurrence
Neoplasm Metastasis
Safety
Control Groups
Disease-Free Survival
Case-Control Studies
Neoplasms
Databases
Mortality
Therapeutics

Keywords

  • Breast cancer
  • Breast conserving surgery
  • Ductal carcinoma in situ
  • Oncoplastic surgery

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

@article{e01cf94821cc4ca9bd3bef64ea0d7b8e,
title = "Oncoplastic breast surgery for the management of ductal carcinoma in situ (DCIS): is it oncologically safe? A retrospective cohort analysis",
abstract = "Background: Few data exist in literature regarding oncoplastic surgery (ONC) and ductal carcinoma in situ (DCIS). The role of ONC in the treatment of DCIS has not been elucidated yet: no case-control study has yet been published on the issue and no long-term oncologic results are reported. Methods: Using the European Institute of Oncology (IEO) institutional breast cancer data base we investigated the oncologic safety of ONC for DCIS comparing a consecutive series of 44 patients who have underwent ONC followed by external irradiation for DCIS (Group A-study group) with 375 patients who received conservation alone followed by external irradiation for DCIS (Group B– control group) in the same period. We excluded patients presenting with secondary tumors or local relapses and those requiring re-excision or completion mastectomy for positive margins. Primary endpoints were disease-free survival (DFS) and ipsilateral breast tumor recurrence (IBTR) within the study group and comparison with the control group. Results: Events rates and death rates were similar in the two groups. The average annual rate of invasive IBTR in group A and B was 1.6{\%} and 1.0{\%} respectively. No difference in the rate of lymphnode metastasis, distant metastasis, contralateral breast cancer, other primary cancer or death was observed across the two groups. Conclusions: Our findings suggest the safety of ONC and irradiation for the management of DCIS extending the indications for conservation in DCIS patients otherwise treated with mastectomy. It provides the best available evidence supporting ONC as a valid treatment option for the management of DCIS.",
keywords = "Breast cancer, Breast conserving surgery, Ductal carcinoma in situ, Oncoplastic surgery",
author = "{De Lorenzi}, Francesca and {Di Bella}, Julien and Patrick Maisonneuve and Nicole Rotmensz and Giovanni Corso and Roberto Orecchia and Marco Colleoni and Giovanni Mazzarol and Mario Rietjens and Pietro Loschi and Stefano Marcelli and Paolo Veronesi and Viviana Galimberti",
year = "2018",
month = "7",
day = "1",
doi = "10.1016/j.ejso.2018.04.015",
language = "English",
volume = "44",
pages = "957--962",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "7",

}

TY - JOUR

T1 - Oncoplastic breast surgery for the management of ductal carcinoma in situ (DCIS)

T2 - is it oncologically safe? A retrospective cohort analysis

AU - De Lorenzi, Francesca

AU - Di Bella, Julien

AU - Maisonneuve, Patrick

AU - Rotmensz, Nicole

AU - Corso, Giovanni

AU - Orecchia, Roberto

AU - Colleoni, Marco

AU - Mazzarol, Giovanni

AU - Rietjens, Mario

AU - Loschi, Pietro

AU - Marcelli, Stefano

AU - Veronesi, Paolo

AU - Galimberti, Viviana

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background: Few data exist in literature regarding oncoplastic surgery (ONC) and ductal carcinoma in situ (DCIS). The role of ONC in the treatment of DCIS has not been elucidated yet: no case-control study has yet been published on the issue and no long-term oncologic results are reported. Methods: Using the European Institute of Oncology (IEO) institutional breast cancer data base we investigated the oncologic safety of ONC for DCIS comparing a consecutive series of 44 patients who have underwent ONC followed by external irradiation for DCIS (Group A-study group) with 375 patients who received conservation alone followed by external irradiation for DCIS (Group B– control group) in the same period. We excluded patients presenting with secondary tumors or local relapses and those requiring re-excision or completion mastectomy for positive margins. Primary endpoints were disease-free survival (DFS) and ipsilateral breast tumor recurrence (IBTR) within the study group and comparison with the control group. Results: Events rates and death rates were similar in the two groups. The average annual rate of invasive IBTR in group A and B was 1.6% and 1.0% respectively. No difference in the rate of lymphnode metastasis, distant metastasis, contralateral breast cancer, other primary cancer or death was observed across the two groups. Conclusions: Our findings suggest the safety of ONC and irradiation for the management of DCIS extending the indications for conservation in DCIS patients otherwise treated with mastectomy. It provides the best available evidence supporting ONC as a valid treatment option for the management of DCIS.

AB - Background: Few data exist in literature regarding oncoplastic surgery (ONC) and ductal carcinoma in situ (DCIS). The role of ONC in the treatment of DCIS has not been elucidated yet: no case-control study has yet been published on the issue and no long-term oncologic results are reported. Methods: Using the European Institute of Oncology (IEO) institutional breast cancer data base we investigated the oncologic safety of ONC for DCIS comparing a consecutive series of 44 patients who have underwent ONC followed by external irradiation for DCIS (Group A-study group) with 375 patients who received conservation alone followed by external irradiation for DCIS (Group B– control group) in the same period. We excluded patients presenting with secondary tumors or local relapses and those requiring re-excision or completion mastectomy for positive margins. Primary endpoints were disease-free survival (DFS) and ipsilateral breast tumor recurrence (IBTR) within the study group and comparison with the control group. Results: Events rates and death rates were similar in the two groups. The average annual rate of invasive IBTR in group A and B was 1.6% and 1.0% respectively. No difference in the rate of lymphnode metastasis, distant metastasis, contralateral breast cancer, other primary cancer or death was observed across the two groups. Conclusions: Our findings suggest the safety of ONC and irradiation for the management of DCIS extending the indications for conservation in DCIS patients otherwise treated with mastectomy. It provides the best available evidence supporting ONC as a valid treatment option for the management of DCIS.

KW - Breast cancer

KW - Breast conserving surgery

KW - Ductal carcinoma in situ

KW - Oncoplastic surgery

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U2 - 10.1016/j.ejso.2018.04.015

DO - 10.1016/j.ejso.2018.04.015

M3 - Article

C2 - 29759643

AN - SCOPUS:85046714706

VL - 44

SP - 957

EP - 962

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 7

ER -