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New data cast doubt over current DCIS treatment

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Experts are calling for a reassessment of the standard of care for women with ductal carcinoma in situ (DCIS) after a large study has shown no reduction in breast cancer-specific mortality in patients treated aggressively with radiotherapy (RT) following lumpectomy or with unilateral mastectomy.

In patients with DCIS who underwent RT after lumpectomy (n=42,250), the rate of breast cancer-specific mortality at 10 years was 0.8 percent – a nonsignficiant difference compared with 0.9 percent for those who underwent lumpectomy alone (n=19,762) (adjusted hazard ratio [HR], 0.81; p=0.10). [JAMA Oncol 2015, doi: 10.1001/jamaoncol.2015.2510]

In patients who underwent unilateral mastectomy for DCIS (n=19,515), the 10-year rate of breast cancer-specific mortality was 1.3 percent – a nonsignficiant difference compared with lumpectomy (adjusted HR, 1.20; p=0.11).

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