The current status of the treatment of ductal carcinoma in situ of Japanese women, especially breast conserving operation in relation to the surgical margin and short term outcome

Tadashi Ikeda, Futoshi Akiyama, Masahiro Hiraoka, Hideo Inaji, Noriaki Ohuchi, Yuichi Takatsuka, Masataka Yoshimoto

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

The indications for a breast conserving operation in the treatment of ductal carcinoma in situ (DCIS) of the breast with clinical manifestations other than mammographically detected calcifications are controversial. A positive surgical margin has been suggested to be an important risk factor for local recurrence after a breast conserving operation. We attempted to clarify the frequency of positive surgical margins when performing breast conserving operations for DCIS, identify the risk factors for positive margins, and also to evaluate the short-term outcome. Between 1988 ancl 1992, 5571 breast cancer cases were surgically treated at the 7 institutions of the authors, of which 375 cases (6.7%) were histologically diagnosed as DCIS. The most frequent clinical manifestation was a tumor in 64% of the cases, followed by nipple discharge in 23% and calcification on mammography in 12%. Of these 375 cases, 242 cases were analyzed. Sixty-six cases had undergone a breast conserving operation. Axillary dissection was not performed in 29 cases. The median follow up period was 61.4 months. The initial surgical margin was positive in 29% of the cases. The most significant factor for a positive surgical margin was young age followed by large tumor size. There were four cases with local recurrence. Three recurrences developed in the same quadrant. All four cases remain alive after total mastectomy. There were no cases with distant metastasis or axillary recurrence. Breast conserving operation for DCIS have shown satisfactory results to date, and when clear surgical margins can be obtained, this procedure, without axillary dissection, should be considered even for patients with clinical manifestations other than mammographically detected calcifications.

Original languageEnglish
Pages (from-to)53-58
Number of pages6
JournalBreast Cancer
Volume5
Issue number1
DOIs
Publication statusPublished - 1998 Jan

Keywords

  • Breast cancer
  • Breast conserving operation
  • Ductal carcinoma in situ
  • Outcome
  • Surgical margin

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)

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