scholarly journals Comparing hypofractionated and conventionally fractionated whole breast irradiation for patients with ductal carcinoma in situ after breast conservation: a propensity score-matched analysis from a national multicenter cohort (COBCG-02 study)

2021 ◽  
Author(s):  
Fiorenza De Rose ◽  
Maria Carmen De Santis ◽  
Bruno Meduri ◽  
Ciro Franzese ◽  
Davide Franceschini ◽  
...  
Keyword(s):  
Propensity Score ◽  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Breast Conservation ◽  
Whole Breast Irradiation ◽  
Breast Irradiation ◽  
Multicenter Cohort ◽  
Conventionally Fractionated

scholarly journals Society of Surgical Oncology–American Society for Radiation Oncology–American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma In Situ

2016 ◽  
Vol 34 (33) ◽  
pp. 4040-4046 ◽  
Author(s):  
Monica Morrow ◽  
Kimberly J. Van Zee ◽  
Lawrence J. Solin ◽  
Nehmat Houssami ◽  
Mariana Chavez-MacGregor ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Ipsilateral Breast Tumor Recurrence ◽  
Breast Conserving Surgery ◽  
Whole Breast Irradiation ◽  
Breast Irradiation ◽  
Margin Width ◽  
American Society

Background Controversy exists regarding the optimal negative margin width for ductal carcinoma in situ (DCIS) treated with breast-conserving surgery and whole-breast irradiation (WBRT). Methods A multidisciplinary consensus panel used a meta-analysis of margin width and ipsilateral breast tumor recurrence (IBTR) from a systematic review of 20 studies including 7883 patients and other published literature as the evidence base for consensus. Results Negative margins halve the risk of IBTR compared with positive margins defined as ink on DCIS. A 2 mm margin minimizes the risk of IBTR compared with smaller negative margins. More widely clear margins do not significantly decrease IBTR compared with 2 mm margins. Negative margins less than 2 mm alone are not an indication for mastectomy, and factors known to impact rates of IBTR should be considered in determining the need for re-excision. Conclusion The use of a 2 mm margin as the standard for an adequate margin in DCIS treated with WBRT is associated with low rates of IBTR and has the potential to decrease re-excision rates, improve cosmetic outcome, and decrease health care costs. Clinical judgment should be used in determining the need for further surgery in patients with negative margins < 2 mm.

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