The research led by Aruna Turaka, MD, a fellow in the Department of Radiation Oncology at Fox Chase rebuffs the conventional opinion that young women with ductal carcinoma in situ, or DCIS, a common form of early breast cancer that arises in and is confined to the mammary ducts are more likely to have recurrences than older women.
DCIS is generally treated with breast-conserving surgery (lumpectomy) and radiation.
"There are discrepancies among past studies that looked at the outcomes of very young women with DCIS treated with radiation, but many suggested a less favourable outcome than for older women," said Turaka.
"Because each of these studies reflects diverse factors, including how the cancer was managed by the surgeons and radiation oncologists, we wanted to look at our institution''s experience in treating DCIS in this population," she added.
At Fox Chase, surgeons will commonly re-excise the tumour site until the pathologists and surgeons have "clear margins," or find no sign of cancer around where the tumour was removed.
General radiation guidelines dictate that the entire affected breast be irradiated. At Fox Chase, additional radiation also is delivered to the site where the cancer was removed. This is called a "boost."
During the study, the physicians examined the records of 440 patients with DCIS treated from 1978 to 2007 at Fox Chase.
Of these, 24 patients were 40 years old or younger. Patients with invasive disease or more than one area involved in the breast were excluded.
Re-excision to obtain wider clear margins was used in 62 percent of all patients, and even more often - 75 percent - in patients 40 or younger.
All women received whole-breast radiotherapy and 95 percent also received a radiation boost.
The recurrence for all women was 7 percent at 10 years and 8 percent at 15 years.
At 15 years, the recurrence rate was 10 percent in patients 40 or younger, 7 percent in those ages 41-54, 11 percent in those ages 55-69, and 4 percent in those 70 and older. The different recurrence rates were not statistically significantly.
"We didn''t find a significant difference in recurrence rates based on age," explains Turaka.
"Our study suggests that when treating DCIS with breast-conserving surgery and radiation, very young age plays a smaller role as a contributor to local recurrence than previously suggested," she added.
The study was presented today at the 50th annual meeting of the American Society for Therapeutic Radiology and Oncology.