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The impact of surgery, radiation, and systemic treatment on outcomes in patients with ductal carcinoma in situ.

AbstractBACKGROUND:
Ductal carcinoma in situ (DCIS) is associated with low rates of mortality. Outcomes are generally assessed in terms of recurrence.
METHODS:
Published studies were abstracted from MEDLINE and other sources. We include articles published through January 31, 2009; 10 publications of five randomized controlled trials and 133 publications of 64 observational studies were reviewed.
RESULTS:
Whole-breast radiation therapy following breast-conserving surgery (BCS) was consistently associated with a reduced incidence of local DCIS recurrence and local invasive carcinoma. Women undergoing mastectomy were less likely than women undergoing lumpectomy with or without radiation to experience local DCIS or invasive recurrence. Tamoxifen use reduced risk of recurrent DCIS or invasive carcinoma.
CONCLUSIONS:
BCS plus radiation and mastectomy appear to yield equivalent outcomes, whereas BCS alone tends to be inferior to mastectomy. Tamoxifen seems helpful in treating DCIS.
AuthorsRobert L Kane, Beth A Virnig, Tatyana Shamliyan, Shi-Yi Wang, Todd M Tuttle, Timothy J Wilt
JournalJournal of the National Cancer Institute. Monographs (J Natl Cancer Inst Monogr) Vol. 2010 Issue 41 Pg. 130-3 ( 2010) ISSN: 1745-6614 [Electronic] United States
PMID20956816 (Publication Type: Journal Article, Review)
Chemical References
  • Antineoplastic Agents
  • Antineoplastic Agents, Hormonal
  • Tamoxifen
Topics
  • Antineoplastic Agents (therapeutic use)
  • Antineoplastic Agents, Hormonal (therapeutic use)
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Breast Neoplasms (drug therapy, mortality, radiotherapy, surgery, therapy)
  • Carcinoma, Ductal, Breast (epidemiology)
  • Carcinoma, Intraductal, Noninfiltrating (drug therapy, mortality, radiotherapy, surgery, therapy)
  • Chemotherapy, Adjuvant (standards)
  • Combined Modality Therapy
  • Disease Progression
  • Female
  • Humans
  • Incidence
  • Mastectomy (methods, statistics & numerical data)
  • Mastectomy, Segmental (statistics & numerical data)
  • Neoplasm Recurrence, Local (epidemiology)
  • Neoplasms, Second Primary (epidemiology, prevention & control)
  • Prognosis
  • Radiotherapy, Adjuvant (methods, statistics & numerical data)
  • Randomized Controlled Trials as Topic (statistics & numerical data)
  • Tamoxifen (therapeutic use)
  • Treatment Outcome

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