Treatment trends and prognosis of breast ductal carcinoma in situ: a single center analysis

Objective: To analyze the changes in treatment patterns, clinical characteristics, treatment outcomes and prognostic factors of ductal carcinoma in situ (DCIS). Methods: Clinical data of 617 female patients admitted to our institution between 2000 and 2013 were retrospectively analyzed. Kaplan-Meier survival analysis was adopted to calculate the local control (LC), disease-free survival (DFS) and overall survival (OS) rates. Log-rank test was utilized to identify the prognostic factors. Results: Along the number of DCIS patients was gradually increased year by year, the proportion of breast conservative surgery was also elevated. However, mastectomy remained the primary surgical method. A total of 374 patients underwent mastectomy, 160 cases received breast conservative surgery plus radiotherapy and 83 underwent breast conservative surgery alone. Postoperatively, 366 patients (83.6%) with positive hormone receptor received hormone therapy and 45 patients (7.3%) underwent chemotherapy. The median follow-up time was 47 months. The 5- year LC, DFS and OS rates were 98.4%, 97.5% and 98.9%, respectively. Univariate analysis demonstrated that Her-2-positive patients obtained worse OS (P = 0.019). Although mastectomy group had more adverse factors compared with breast conservative surgery with or without radiotherapy groups, similar survival results were obtained among three groups. Mastectomy yielded better LC and DFS compared with breast conservative surgery alone. Conclusions: DCIS patients obtain favorable clinical prognosis between the breast conservative surgery and mastectomy groups. The LC rate in the mastectomy group is better than that in the breast conservative surgery group. (authors)