Young Age is not Associated with Increased Local Recurrence for DCIS Treated by Breast-conserving Surgery and Radiation

Abstract

Background—We report local recurrence (LR) after breast-conserving surgery and radiation (BCS + RT) for ductal carcinoma in situ (DCIS) to determine outcomes for patients aged ≤ 40 years compared with older women. Methods—The study included 440 women with DCIS treated from 1978 to 2007. All patients received whole-breast radiotherapy with a boost in 95% of cases. Demographics, characteristics, surgical and adjuvant treatments were analyzed for an effect on LR. Results—Median age was 56.5 years with 24 patients aged ≤ 40. Median DCIS size was 0.8 cm. Re-excision was required in 62% of patients, and in 75% of those aged ≤ 40. Tamoxifen was used in 22%, but only 1 patient aged ≤ 40. Median follow-up was 6.8 years. Actuarial LR was 7% (95% confidence interval of 4–11%) at 10 years and 8% (5–14%) at 15 years. There was no difference in LR by age (p=0.76). Conclusions—The long-term risk of LR after BCS + RT for DCIS is low, even in patients ≤ 40 years. This may be due to patient selection for small size, high utilization of re-excision and radiation boost. Young age may be a smaller contributor to LR risk in DCIS than previously suggested.