This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vicini, F. A. Articles by Recht, A. Search for Related Content PubMed PubMed Citation Articles by Vicini, F. A. Articles by Recht, A.

Age at Diagnosis and Outcome for Women With Ductal Carcinoma-In-Situ of the Breast: A Critical Review of the Literature

From the Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, and Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Address reprint requests to Frank A. Vicini, MD, Department of Radiation Oncology, William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI 48073; email: fvicini{at}beaumont.edu

PURPOSE: Patients younger than 35 to 45 years old at the time of diagnosis of invasive breast cancer have been found to have a worse prognosis than older patients in many studies. However, the impact of patient age at diagnosis on the outcome of treatment with either lumpectomy and radiation therapy (RT) or mastectomy for patients with ductal carcinoma-in-situ (DCIS) of the breast has not been extensively analyzed.

MATERIALS AND METHODS: Articles addressing the effect of patient age at diagnosis on the outcome of treatment of DCIS with lumpectomy and RT or mastectomy were identified through the MEDLINE and CancerLit databases and reference lists of relevant articles. Studies were reviewed to determine the impact of patient age at diagnosis on clinical and pathologic features of DCIS, the influence of age on outcome after lumpectomy and RT, and the impact of age on outcome after mastectomy.

RESULTS: DCIS in younger patients more frequently contains adverse prognostic pathologic factors and extends over a greater distance in the breast than in older patients. In series with adequate follow-up, younger patients treated with lumpectomy and RT had a significantly higher rate of local recurrence than older patients, especially for invasive local recurrences. Some studies have suggested that careful attention to margin status and excising larger volumes of tissue can reduce this difference substantially. No available data show that younger patients have better long-term cancer-free survival rates if treated by mastectomy rather than lumpectomy and RT.

CONCLUSION: Successful treatment of younger patients with DCIS with lumpectomy and RT requires careful attention to patient evaluation, selection, and surgical technique. When this is done, age at diagnosis should not be a contraindication to breast-conserving therapy.

This article has been cited by other articles:

				E. S. Hwang, J. L. McLennan, D. H. Moore, B. B. Crawford, L. J. Esserman, and J. L. Ziegler Ductal Carcinoma In Situ in BRCA Mutation Carriers J. Clin. Oncol., February 20, 2007; 25(6): 642 - 647. [Abstract] [Full Text] [PDF]

				B. G. Haffty, Q. Yang, M. Reiss, T. Kearney, S. A. Higgins, J. Weidhaas, L. Harris, W. Hait, and D. Toppmeyer Locoregional Relapse and Distant Metastasis in Conservatively Managed Triple Negative Early-Stage Breast Cancer J. Clin. Oncol., December 20, 2006; 24(36): 5652 - 5657. [Abstract] [Full Text] [PDF]

				B. D. Smith, B. G. Haffty, A. Hurria, D. H. Galusha, and C. P. Gross Postmastectomy Radiation and Survival in Older Women With Breast Cancer J. Clin. Oncol., October 20, 2006; 24(30): 4901 - 4907. [Abstract] [Full Text] [PDF]

				B. D. Smith, B. G. Haffty, T. A. Buchholz, G. L. Smith, D. H. Galusha, J. E. Bekelman, and C. P. Gross Effectiveness of radiation therapy in older women with ductal carcinoma in situ. J Natl Cancer Inst, September 20, 2006; 98(18): 1302 - 1310. [Abstract] [Full Text] [PDF]

				H. J. Burstein, K. Polyak, J. S. Wong, S. C. Lester, and C. M. Kaelin Ductal Carcinoma in Situ of the Breast N. Engl. J. Med., April 1, 2004; 350(14): 1430 - 1441. [Full Text] [PDF]

				M. Morrow, E. A. Strom, L. W. Bassett, D. D. Dershaw, B. Fowble, J. R. Harris, F. O'Malley, S. J. Schnitt, S. E. Singletary, and D. P. Winchester Standard for the Management of Ductal Carcinoma In Situ of the Breast (DCIS) CA Cancer J Clin, September 1, 2002; 52(5): 256 - 276. [Abstract] [Full Text] [PDF]