DCIS Predicts Risk of Local Recurrence

“Another study has confirmed that the DCIS Score independently predicts the risk of local recurrence in a population of patients with ductal carcinoma in situ (DCIS) who were treated with breast-conserving surgery alone (BCS), analysis of the Ontario CDIS cohort indicates.

“In a cohort of 718 patients treated with BCS alone, there were 100 local recurrences (LR), 44 of them being DCIS local recurrences and 57 being invasive (one case developed an invasive local recurrence after a DCIS local recurrence).

“The overall 10-year rate of local recurrence was 19.2%

“Approximately two-thirds of the women in the study had a low-risk DCIS Score; 16.6% had an intermediate risk DCIS score and 21.2% had a high-risk DCIS score.”

Lumpectomy Versus Mastectomy for Early-Stage Breast Cancer

Every woman diagnosed with early-stage breast cancer faces a decision about what type of surgery to have. Together with her doctors, she will have to choose between breast-conserving surgery (BCS), also called lumpectomy, and mastectomy. BCS preserves the breast, removing the tumor and a rim of surrounding tissue, whereas mastectomy removes the entire breast. Patients with early-stage disease (with the main tumor less than 4 cm across and 3 or fewer lymph nodes positive for cancer) are usually eligible for either BCS or mastectomy. More importantly, lumpectomy followed by radiation is just as effective as mastectomy. One would think most women would choose BCS as a less invasive (and breast-conserving!) procedure, but the numbers tell a different story. Continue reading…

Breast Conserving Therapy Shows Survival Benefit Compared to Mastectomy in Early-Stage Patients

Editor’s note: Women with early-stage breast cancer have surgery to remove their tumors. They can choose between a mastectomy to remove the entire breast or a lumpectomy to remove the diseased part of the breast (breast conserving therapy, or BCT). Until now, it was thought that a mastectomy and BCT had similar results in terms of long-term survival for a patient. But a new study shows that BCT offers better survival for women who are PR-positive or ER-positive. Further studies are needed to figure out why. The researchers speculate it may have to do with the radiation treatment usually given just after BCT to keep the cancer from returning. Unfortunately, there appear to be socioeconomic barriers to receiving BCT instead of a mastectomy.

“When factoring in what is now known about breast cancer biology and heterogeneity, breast conserving therapy (BCT) may offer a greater survival benefit over mastectomy to women with early stage, hormone-receptor positive disease, according to research from The University of Texas MD Anderson Cancer Center.

“The study findings defy the conventional belief that the two treatment interventions offer equal survival, and show the need to revisit some standards of breast cancer practice in the modern era.

“The research was presented at the 2014 Breast Cancer Symposium by Catherine Parker, MD, formerly a fellow at MD Anderson, now at the University of Alabama Birmingham.”