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Margin status not linked to recurrence, survival in DCIS
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SAN FRANCISCO — Margin status was not predictive of locoregional recurrence, breast cancer-specific survival or OS among patients with ductal carcinoma in situ who underwent breast-conserving surgery, according to retrospective study results presented at the Breast Cancer Symposium.
The findings raise questions about whether re-excision for close margins is necessary, researchers wrote.
Rachel Gentile, BS, of Medical College of Wisconsin, and colleagues evaluated data from 253 patients with ductal carcinoma in situ (DCIS) between 2003 and 2010. The median age of patients was 57 years (range, 21-89), and 79% were non-Hispanic white.
A majority of patients had ER–positive disease (78%). In addition to breast-conserving surgery, 67% of patients underwent radiation therapy and 46% received anti-endocrine therapy.
Researchers defined close margins as ˂2 mm and negative margins as ≥2mm. Overall, 63% of patients had negative margins, 29% had close margins and one patient had a positive margin. Researchers were unable to determine margin status in 7% of patients.
After a median follow-up of 5 years, OS was 96%.
Locoregional recurrence occurred in 13 patients, five of whom had close margins, seven of whom had negative margins and one of whom had an unknown margin. The median time to recurrence was 4.9 years.
Results of a multivariate analysis indicated locoregional recurrence was more likely to occur among patients aged older than 70 years compared with those aged 50 to 69 years (HR=6.7; 95% CI, 1.7-25.4). Patients with PR-negative tumors also were more likely to experience locoregional recurrence (HR=5.7; 95% CI, 1.7-19.5).
OS outcomes were less favorable among patients who did not receive radiation therapy compared with those who did (HR=4.3; 95% CI, 1.5-12.6).
Results showed no variables were significantly associated with breast cancer-specific survival.
“In this cohort of patients with DCIS treated with breast conserving surgery, age and PR status were the only predictors of locoregional recurrence,” Gentile and colleagues wrote. “Margin status was not predictive of locoregional recurrence, breast cancer-specific survival or OS. This data suggests that routine re-excision for close margins may not be warranted.”
For more information:
Gentile R. Abstract #98. Presented at: Breast Cancer Symposium; Sept. 4-6, 2014; San Francisco.
Disclosures: The researchers report no relevant financial disclosures.