An assessment of extensive intraductal component as a risk factor for local recurrence after breast-conserving therapy

J Jacquemier,H Brandone,J-M Kurtz,Y Ayme,Jm Spitalier,R Amalric

doi:10.1038/bjc.1990.195

Abstract

The influence of extensive intraductal component (EIC) on local recurrence risk was studied for 496 patients with stage I-II infiltrating ductal cancers treated by conservative surgery and irradiation. EIC was diagnosed in 65 of 231 (28%) premenopausal and 41 of 265 (15.5%) post-menopausal patients. Local recurrence risk was markedly increased in EIC+ patients (5-year actuarial risk 18% versus 8% without EIC, P less than 0.001), but this effect appeared limited to premenopausal patients. Local recurrence risk increased with increasing degree of EIC. EIC with more than 50% intraductal carcinoma was more prevalent in patients younger than 40, perhaps accounting to some degree for the higher local recurrence rates observed in younger patients. The presence of EIC had no influence on overall survival, on median time to local recurrence, or on short-term survival after local failure. The usefulness of EIC as a risk factor for local recurrence is discussed.

Highlights

In only eight instances was extensive DCIS diagnosed within the tumour without some degree of intraductal carcinoma being identified in the periphery, and in none of these was a local recurrence observed
extensive intraductal component (EIC) + patients with more than 50% DCIS had significantly more local recurrences than those with 25-50% DCIS (Table IT), whereas the local failure rate in the latter group was only slightly higher than in the EIC- group
This analysis points out certain characteristics which may limit the degree of usefulness of EIC as a risk factor, perhaps explaining why its importance has not been uniformly recognised by other groups examining more limited case material (Fisher et al, 1986; Calle et al, 1986)

Summary

Objectives

The purpose of the current paper is to examine more closely the potential influence of EIC on local recurrence risk, with a detailed comparison of our results with those of the Harvard group

Methods

Results

Discussion

Conclusion