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Radiation plus lumpectomy associated with better survival in women with DCIS

September 10, 2018

By Sarah Warr

Often found during mammography, ductal carcinoma in situ (DCIS) is the most common type of breast cancer. Despite being referred to as stage 0, approximately three per cent of women with DCIS will die of breast cancer within 15 years of their diagnosis. According to a recent study from Women’s College Research Institute (WCRI) senior scientist, Dr. Steven Narod, treatment with lumpectomy and radiation was associated with lower mortality among patients with DCIS, compared to those who were treated with mastectomy – a much more extensive surgery.

The study, published in JAMA Open, analyzed treatments (including lumpectomy plus radiation, lumpectomy alone and mastectomy) and outcomes for more than 140,000 U.S. women who had DCIS. The scientists found that there was a 25 per cent reduction in deaths among patients with DCIS who received both lumpectomy and radiation. These results suggest that in a small proportion of patients with DCIS the cancer has spread beyond the breast at the time of diagnosis and can be treated successfully with radiotherapy, in combination with lumpectomy. This observation supports Dr. Narod’s previous position that DCIS better resembles a small invasive cancer rather than a precursor lesion.

Although the clinical benefit of lumpectomy plus radiation was small, it is interesting that radiation had a beneficial effect on DCIS mortality. This beneficial effect was also much stronger for young women, black women and women with large DCIS lesions. Future studies in this area will help scientists examine how the various mechanisms of radiation affects survival in patients with DCIS.

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