Ob/Gyn Medical News about multifocality in ductal carcinoma in situ

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Significance of multifocality in ductal carcinoma in situ: outcomes of women treated with breast-conserving therapy
Journal of Clinical Oncology, 01/11/08

Rakovitch E et al. - In a study to evaluate the significance of multifocality and outcomes of women with multifocal DCIS treated with breast-conserving therapy, it seems that multifocality is a significant predictor of local recurrence in women who receive breast-conserving surgery for DCIS without radiotherapy; however, low recurrence rates can be achieved if adjuvant radiation is administered

Methods

Records of patients treated with breast-conserving surgery for DCIS were reviewed
Multivariate analyses were performed to evaluate the effects of multifocality and other prognostic factors on the rate of local recurrence

Results

Of 615 cases of DCIS reviewed, 41% received breast-conserving surgery and 40% received breast-conserving surgery plus radiation
Multifocality, radiation treatment, margin width >= 4 mm, and high nuclear grade were associated with risk of local recurrence
The detrimental effect of multifocality was limited to women who did not receive radiotherapy; the local recurrence–free survival rate at 10 years was 59% for women with multifocal disease and 80% for women without multifocality
Among women treated with breast-conserving surgery plus radiation, there was no difference in 10-year local recurrence–free survival
There was no association between multifocality and development of invasive recurrence

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