Background.
DCIS treated by
mastectomy ensures high local control rates. There is limited data on risk for relapse and lack of clear indication for adjuvant
radiation therapy (RT). We report a retrospective review on a population of
DCIS patients treated with
mastectomy. The objective was to identify the overall incidence of relapse, risk factors for local recurrence, and accordingly for whom adjuvant postmastectomy RT may be considered. Methods. This is an IRB-approved retrospective study on a prospective
breast cancer database. From 1997 to 2007, we identified 969 patients with diagnoses of
DCIS, among them 211 breasts in 207 patients were treated with
mastectomy and comprise the study group. Results. With a median followup of 55 months (4.6 years) the 10-year relapse-free survival is 97%. Two of 211 breasts (0.9%) treated with
mastectomy developed a local-regional recurrence. Both the relapses were among patients defined as having <1 mm final
mastectomy margin. Conclusions. The rare local relapse after
mastectomy limits our ability to reliably identify risk factors for relapse. The consideration for postmastectomy RT should be based on an individualized risk evaluating surgical technique used, presence of BRCA mutation, grade and extent of
tumor, and proximity of lesion to the margin of resection.