Findings debunk theory that DCIS recurrence varies with age
WEDNESDAY, Sept. 24 (HealthDay News) -- Young women diagnosed with a common form of early-stage breast cancer called ductal carcinoma in situ (DCIS) are no more likely to have recurrences than older women with the disease, a new study finds.
The presumption has been that women aged 40 and younger, when diagnosed with DCIS, were more likely to have it recur, noted Dr. Aruna Turaka, a fellow in the department of radiation oncology at Fox Chase Cancer Center, Philadelphia. But her new study -- which she is due to present Wednesday at the American Society for Therapeutic Radiology and Oncology annual meeting in Boston -- found otherwise.
According to the U.S. National Cancer Institute, DCIS is a noninvasive condition in which abnormal cells are found in the lining of a breast duct; the abnormal cells have not spilled out from the duct to other breast tissues, however. About 62,000 cases of in situ cancer are diagnosed each year, according to the American Cancer Society.
In the new study, "We looked into our institutional database at Fox Chase from 1978 to 2007," Turaka explained. All of the DCIS patients were treated with breast-conserving surgery and radiation.
The researchers examined the records of 440 patients with DCIS; 24 were 40 or younger; the rest were aged 41 and older. The team then looked at follow-up records from 10 and 15 years after treatment.
"The overall recurrence over 10 years was 7 percent, and at 15 years, 8 percent," she said. Ranked by age, Turaka found that at the 15-year follow-up, 10 percent of women 40 and under had a cancer recurrence, while 7 percent of those aged 41-54 did, 11 percent of those aged 55-69 did, and 4 percent of those aged 70 and above did.
"It shows there is a trend toward increased recurrence in younger versus older, but it is not statistically significant," Turaka said.
Prior studies did find a higher risk of recurrence in younger women with DCIS, she said, but those studies also had some methodology problems, including using varying definitions for DCIS.
One expert applauded the new study.
"They have debunked the commonly held belief that age alone is a risk factor for recurrence after treatment of DCIS," said Dr. Ann Partridge, a medical oncologist and researcher at the Dana-Farber Cancer Institute and Brigham and Women's Hospital, in Boston.
Partridge has published about women's anxiety over their prognosis when diagnosed with a DCIS. She found that women are typically highly anxious, even though their risk of recurrence or of developing invasive breast cancer is low.
"I think this is a good study," Partridge said, although it does have limitations. For instance, she said, it is a single-institution study. However, Fox Chase physicians "are doing what they should be doing," Partridge said, explaining that the institution is careful about selecting the right treatment for the right patients, based on the characteristics of their cancer.
There's more on DCIS at breastcancer.org.
SOURCES: Aruna Turaka, M.D., fellow, department of radiation oncology, Fox Chase Cancer Center, Philadelphia; Ann Partridge, M.D., medical oncologist and researcher, Dana-Farber Cancer Institute and Brigham & Women's Hospital, Boston; Sept. 24, 2008, presentation, American Society for Therapeutic Radiology and Oncology annual meeting, Boston
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