Radiation therapy for intraductal carcinoma. Is it an equal alternative?
M. J. Silverstein, J. R. Waisman, E. D. Gierson, W. Colburn, P. Gamagami and B. S. Lewinsky
Breast Center, Van Nuys, Calif 91405.
Of 213 consecutive patients with intraductal carcinoma, 109 were
selectively treated with mastectomy and 104 with radiation therapy. There
were eight local recurrences, seven in patients treated with radiation
therapy and one in a patient treated with mastectomy. Histologically, there
were 110 comedocarcinomas and 103 noncomedocarcinomas. Seven local
recurrences occurred in patients with comedocarcinomas and one in a patient
with a noncomedo tumor. Three (38%) of eight local recurrences (all comedo)
were invasive. The 5-year actuarial survival for all subgroups was 100%.
The median follow-up was 51 months. Intraductal carcinoma is unlikely to
metastasize to axillary lymph nodes, and routine dissection is unnecessary.
Ductal carcinoma in situ of the comedo variety is more aggressive and more
likely to recur than its noncomedo counterpart. We currently view
conservative therapy for patients with intraductal comedocarcinoma with
caution.
