October 12th, 2009

Young Women with DCIS Have Higher Risk of Recurrence


After treatment of breast ductal carcinoma in situ (DCIS) with breast-conserving surgery and radiation therapy, women age 44 or younger have a higher rate of recurrence than older women. These results were presented at the ASCO 2009 Breast Cancer Symposium.

Ductal carcinoma in situ (DCIS) refers to a condition in which abnormal cells are found in the lining of a breast duct, but have not spread outside of the duct to other tissues in the breast. It is most commonly detected by screening mammography. If not treated, some cases of DCIS may progress to invasive breast cancer.

Treatment of DCIS often involves breast-conserving surgery (lumpectomy) and radiation therapy. Although recurrence rates after treatment tend to be low, few previous studies of DCIS have focused on young women.

To explore outcomes among young women with DCIS, researchers in Ontario conducted a study among women age 50 or younger. Between 1994 and 2003, 1,015 young women were diagnosed with DCIS; 583 of these women were treated with breast-conserving surgery and radiation therapy.

Women were followed for a median of 8.5 years.

  • Recurrence rates were 20% for women age 40 or younger, 19% for women age 40-44, and 12% for women age 45 to 50. By comparison, recurrence rates for women over age 50 are typically 10-15%.

This study suggests that women under the age of 45 tend to have higher rates of recurrence than older women after treatment of DCIS with breast-conserving surgery and radiation therapy.

In a prepared statement, the lead author of the study noted: “We don’t yet know why younger women with DCIS have a higher rate of recurrence compared with older women. Further research is necessary to determine the causes of this difference and to determine the best treatment for younger women with DCIS. It is important to add that these findings do not imply that all young women with DCIS need to undergo more aggressive surgery, such as a mastectomy, to reduce recurrence risk.”

Reference: Kong I, Rakovitch E, Taylor C, Nofech-Moses S, Hannah W, Paszat L. Outcomes of young women with DCIS treated with breast-conserving surgery and radiotherapy: A population-based analysis. Presented at the American Society of Clinical Oncology (ASCO) 2009 Breast Cancer Symposium. Abstract 127.

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