Women with an early type of breast cancer have a good chance of surviving even if the disease returns after the initial treatment, doctors said on Friday.
Ductal carcinoma in situ (DCIS) is a non-invasive early cancer that is restricted to the milk ducts in the breast. It is becoming more common as mammograms pick up early signs of the disease, but how it is treated varies.
If DCIS is extensive, a mastectomy may be necessary. Otherwise patients may have a lumpectomy, in which only part of the breast is removed, which may be followed by a course of radiotherapy to destroy any cancerous cells left behind.
Professor Dennis Holmes of the University of Southern California Keck School of Medicine told the Fourth European Breast Cancer Conference that although the risk of the cancer returning is higher with a lumpectomy, long-term survival is the same.
“These results show that nearly all patients with DCIS whose cancer recurs can be treated successfully, whether or not DCIS recurs as new DCIS or invasive cancer,” he said.
About half of recurrences of DCIS are invasive cancer which is more serious because it can spread to other parts of the body.
Better than 90 percent survival
In a study of 1,136 patients, Holmes and his colleagues said 30 percent of women who had a lumpectomy had a recurrence after 10 years compared to 18 percent who a lumpectomy and radiotherapy and 1.8 percent who had chosen to have a mastectomy.
“The 10-year rate of deaths from all causes and from breast cancer specifically is statistically similar across all three groups,” he added.
In a small group of patients whose DCIS returned as invasive cancer, the chances of survival were better than 90 percent.
Holmes stressed that patients must be rigorously monitored so that any signs of a recurrence can be picked up and treated as early as possible.
“Mastectomy is associated with the lowest risk of local recurrence but provides no survival advantage when compared with breast conservation therapy,” he added.
About 4,000 delegates from 80 countries are attending the five-day meeting that ends on Saturday.
