Risk of Breast Cancer Recurrence May Depend on Treating Surgeon
Ductal carcinoma in situ (DCIS), or non-invasive breast cancer, is typically treated with either breast-conserving surgery—with or without follow-up radiation—or mastectomy. The treatment choice depends on clinical factors, the treating surgeon, and patient preferences. Long-term health outcomes (disease-free survival) depend on the treatments received. According to a study published in the Journal of the National Cancer Institute, however, health outcomes also are associated with the treating surgeon.
To determine the comparative effectiveness of treatment strategies, Andrew W. Dick, Ph.D., of the RAND Corporation and colleagues conducted a retrospective study of women diagnosed with DCIS between 1985 and 2000 with as many as 18 years of follow-up. They identified the women through two large tumor registries, the Monroe County (New York) tumor registry, and the tumor registry at the Henry Ford Health System in Detroit.
The researchers collected extensive data on the patients, including the rate of ipsilateral recurrence, or recurrent breast cancer in the same breast; whether the women had been treated with mastectomy or breast conserving surgery—with or without radiation therapy; and their margin status (margin of tissue surrounding their resected tumors). They defined margins as positive (in which cancer cells extend to the edge of the resected tissue), negative (cancer cells are more than 2 millimeters away from the edge of the tissue), or close (in which cancer cells are present within two millimeters of the edge).