Overview of the randomized trials of radiotherapy in ductal carcinoma in situ of the breast

• Individual patient data were available for all four of the randomized trials that began before 1995, and that compared adjuvant radiotherapy vs no radiotherapy following breast-conserving surgery for ductal carcinoma in situ (DCIS). A total of 3729 women were eligible for analysis. Radiotherapy reduced the absolute 10-year risk of any ipsilateral breast event (ie, either recurrent DCIS or invasive cancer) by 15.2% (SE 1.6%, 12.9% vs 28.1% 2 P <.00001), and it was effective regardless of the age at diagnosis, extent of breast-conserving surgery, use of tamoxifen, method of DCIS detection, margin status, focality, grade, comedonecrosis, architecture, or tumor size. The proportional reduction in ipsilateral breast events was greater in older than in younger women (2P < .0004 for difference between proportional reductions; 10-year absolute risks: 18.5% vs 29.1% at ages <50 years, 10.8% vs 27.8% at ages ≥ 50 years) but did not differ significantly according to any other available factor. Even for women with negative margins and small low-grade tumors, the absolute reduction in the 10-year risk of ipsilateral breast events was 18.0% (SE 5.5, 12.1% vs 30.1%, 2P = .002). After 10 years of follow-up, there was, however, no significant effect on breast cancer mortality, mortality from causes other than breast cancer, or all-cause mortality.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Adult

Aged

Antineoplastic Agents, Hormonal/therapeutic use

Breast Neoplasms/drug therapy

Carcinoma, Ductal, Breast/epidemiology

Carcinoma, Intraductal, Noninfiltrating/drug therapy

Chemotherapy, Adjuvant

Combined Modality Therapy

Female

Humans

Mastectomy, Segmental

Meta-Analysis as Topic

Middle Aged

Multicenter Studies as Topic/statistics & numerical data

Neoplasm Recurrence, Local/epidemiology

Neoplasms, Second Primary/epidemiology

Radiotherapy, Adjuvant/statistics & numerical data

Randomized Controlled Trials as Topic/statistics & numerical data

Tamoxifen/therapeutic use

Publikations- och innehållstyp

art (ämneskategori)

ref (ämneskategori)