Radiotherapy for women with a DCIS

Today in Sweden, according to our national guidelines we do not give radiotherapy to women with a DCIS, grade 1 or 2, smaller than 15mm. We know that we can reduce the number of local recurrences even in this group but the absolute benefit is very low and we think the disadvantage is larger than the gain.

Based on current knowledge and the recent paper, we can inform the women that we do not improve their survival chances with radiotherapy but we know that we reduce local recurrences. DCIS is a disease with very good prognosis regarding survival. Local recurrence rate is however high. We will continue to look for subgroups where radiotherapy safely can be omitted. We will also look for subgroups where the best option might be a mastectomy, with or without a breast reconstruction. We will need to look at tumour biology in a new way and, we need to find that way.

 

 

Bibliographic Reference:

Warnberg F et al.: "Effect of Radiotherapy After Breast-Conserving Surgery for Ductal Carcinoma in Situ: 20 Years Follow-Up in the Randomized SweDCIS Trial", J Clin Oncol. 2014 Oct 13. pii: JCO.2014.56.2595. [Epub ahead of print]

 

 

 

 

 

Fredrik Wärnberg

Uppsala University, Uppsala, Sweden