Multiple surgeries may be unnecessary for some stage zero breast cancer patients
MD Anderson staff
Patients with stage zero breast cancer, also known as ductal carcinoma in situ, who undergo breast-conserving surgery that results in narrow negative margins may not need additional surgeries if radiation therapy is performed, according to a recent analysis by MD Anderson researchers.
The study, led by Audree Tadros, M.D., and Henry Kuerer, M.D., Ph.D., of the Breast Surgical Oncology department, was conducted to clarify the benefits of radiation therapy in preventing recurrence of stage zero breast cancer in patients who had breast-conserving surgery with less than 2 mm of tumor-free tissue surrounding the tumor in the excised specimen. The optimal treatment strategy for such patients is not established.
“Many multidisciplinary groups currently use the 2-mm margin as an absolute indication for repeat surgery,” Kuerer said.
He and colleagues looked at the records of nearly 1,500 stage zero breast cancer patients who underwent breast-conserving surgery at MD Anderson between 1996 and 2010. Some patients underwent radiation therapy and some did not. The researchers compared the recurrence rates of patients with negative surgical margins greater than or equal to 2 mm and patients with negative margins less than 2 mm in the radiation and no-radiation groups.
Among patients who had undergone radiation therapy, recurrence rates of those with negative surgical margins greater than or equal to 2 mm and those with margins less than 2 mm did not differ significantly. But among patients who had not undergone radiation therapy, recurrence rates of those with surgical margins greater than or equal to 2 mm was significantly lower.
“Patients with stage zero breast cancer and margins less than 2 mm may not need repeat surgery if they receive radiation therapy,” Kuerer concluded. “Each case needs to be evaluated by a multidisciplinary team, taking into account the patient’s age, the extent of margin involvement, and the patient’s preferences.”
Read more about this study in the September edition of OncoLog.