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WESTPORT, Jun 28 (Reuters Health) - Radiation therapy may be indicated for women who have positive resection margins after mastectomy for ductal carcinoma in situ (DCIS), according to long-term outcomes data on three patients.
"We treated a small number of patients...but they seem to have benefited," investigator Dr. James M. Metz told Reuters Health. Dr. Metz and Dr. Lawrence J. Solin, of the University of Pennsylvania in Philadelphia, reviewed the records of 287 patients who had been treated with postmastectomy radiotherapy at their institution between 1978 and 1992. They identified three patients with ductal carcinoma in situ who underwent radiotherapy because of positive margins.
All three patients were alive and recurrence-free 7.1 to 19.4 years after treatment. Moreover, none experienced any significant complications resulting from radiation therapy, according to a report in the June issue of the American Journal of Clinical Oncology.
The women received "...4,275-5,000 cGy to the chest wall in 200-225 cGy fractions," the investigators explain in the report. In addition, one woman received a bolus to the chest wall every other day, and another "...was treated with a scar boost after chest wall irradiation."
Because the occurrence of positive resection margins after surgery for ductal carcinoma in situ is rare, few data are available on the optimal management of such patients, Drs. Metz and Solin note. But Dr. Metz believes that the incidence of positive margins after mastectomy in women with ductal carcinoma in situ may be on the rise.
"The incidence of ductal carcinoma in situ has increased in recent years...so we may be faced with this more often," he said in the interview.
Am J Clin Oncol 1999;22:215-217
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