Radiation Therapy Plus Lumpectomy Linked to Lower Mortality in DCIS

In women with ductal carcinoma in situ (DCIS) lumpectomy plus radiation was linked with a small clinical benefit in lowered risk of breast cancer death compared with lumpectomy or mastectomy alone, revealed study.

Why The Research Is Interesting: Patients with DCIS are often treated with radiation after lumpectomy, although it has remained unclear whether this can reduce the risk of dying from breast cancer.

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‘A small improvement in breast cancer survival was associated with radiation plus lumpectomy for ductal carcinoma in situ (DCIS).’

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Who and When: More than 140,000 U.S. women who had DCIS between 1998 and 2014; this study compared lumpectomy plus radiation vs. lumpectomy alone, lumpectomy vs. mastectomy, and lumpectomy plus radiation vs. mastectomy

What (Study Measures and Outcomes): Use of radiation and/or extent of surgery (exposures); breast cancer mortality rates within 15 years (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Advise to Omit RT After Lumpectomy Mostly Not Implemented
After a lumpectomy, a breast-sparing or breast-conserving operation, radiation usually is given to the breast to reduce the chance of the cancer returning.

Authors: Steven A. Narod, M.D., of Women's College Research Institute, in Ontario, Canada, and co-authors

The absolute risk reduction was 0.27 percent, making it necessary to treat 370 women to save one life.

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Study Limitations: Some data were missing; investigators didn't have information on tamoxifen use; treatments in the study population weren't randomly assigned; and the possibility remains that the decision to undergo radiotherapy was associated with other favorable prognostic factors.

Related Material: The invited commentary, "Systemic Effects of Radiotherapy in Ductal Carcinoma In Situ," by Mira Goldberg, M.D., and Timothy J. Whelan, B.M., B.Ch., of McMaster University, Ontario, Canada, also is available on the For The Media website.

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To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jamanetworkopen.2018.1100)

Editor's Note: The article contains conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Source-Eurekalert