Boost radiotherapy in young women with ductal carcinoma in situ: a multicentre, retrospective study of the Rare Cancer Network

Aurelius Omlin, Maurizio Amichetti, David Azria, Bernard F. Cole, Philippe Fourneret, Philip Poortmans, Diana Naehrig, Robert C. Miller, Marco Krengli, Cristina Gutierrez Miguelez, David Morgan, Hadassah Goldberg, Luciano Scandolaro, Pauline Gastelblum, Mahmut Ozsahin, Dagmar Dohr, David Christie, Ulrich Oppitz, Ufuk Abacioglu, Guenther Gruber

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126 Scopus citations


Background: Outcome data in young women with ductal carcinoma in situ (DCIS) are rare. The benefits of boost radiotherapy in this group are also unknown. We aimed to assess the effect of boost radiotherapy in young patients with DCIS. Methods: We included 373 women from 18 institutions who met the following inclusion criteria: having tumour status Tis and nodal status (N)0, age 45 years or younger at diagnosis, and having had breast-conserving surgery. 57 (15%) patients had no radiotherapy after surgery, 166 (45%) had radiotherapy without boost (median dose 50 Gy [range 40-60]), and 150 (40%) had radiotherapy with boost (60 Gy [53-76]). The primary outcome was local relapse-free survival. Findings: Median follow-up was 72 months (range 1-281). 55 (15%) patients had local relapse. Local relapse-free survival at 10 years was 46% (95% CI 24-67) for patients given no radiotherapy, 72% (61-83) for those given radiotherapy without boost, and 86% (78-93) for those given radiotherapy and boost (difference between all three groups, p<0·0001). Age, margin status, and radiotherapy dose were significant predictors of local relapse-free survival. Compared with patients who had no radiotherapy, those who had radiotherapy had a decreased risk of local relapse (without boost, hazard ratio 0·33 [95% CI 0·16-0·71], p=0·004; with boost, 0·15 [0·06-0·36], p<0·0001). Interpretation: In the absence of randomised trials, boost radiotherapy should be considered in addition to surgery for breast-conserving treatment for DCIS.

Original languageEnglish
Pages (from-to)652-656
Number of pages5
JournalThe Lancet Oncology
Issue number8
StatePublished - Aug 2006
Externally publishedYes

Bibliographical note

Funding Information:
This study was funded partly by the US National Cancer Institute (CA-75362). We thank the Rare Cancer Network for making this study possible.


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