2009
ASCO Breast Cancer Symposium
Researchers in Canada have found that women aged 44 and younger were
almost twice as likely to have cancer recurrence following breast conservation
surgery and radiation therapy for ductal carcinoma in situ compared with women
aged 45 to 50.
Results of a retrospective study showed that the rate of recurrence was
20% in women aged 40 and younger (n=70) compared with 19% for women 40 to 44
(n=195) and 12% for women 45 to 50 (n=356).
The HR for recurrence in women younger than 40 was 1.83 (95% CI,
1.00-3.36); it was 1.64 for those aged 40 to 44 (95% CI, 1.06-2.53), even after adjusting for the use of boost radiation, nuclear grade-3 and year of diagnosis.
This is preliminary data and further work is needed to better
understand why younger women have higher recurrence rates, as well as to
determine the optimal treatment for young women with DCIS, said Iwa
Kong, MD, a breast radiation oncology research fellow at the Sunnybrook Health
Sciences Center, Toronto. She presented the results at the 2009 Breast Cancer
Symposium in San Francisco.
In a press release, she added that these results do not suggest that
all younger women should undergo more aggressive surgery.
Researchers evaluated the rate of recurrence among 624 women in Ontario
aged 50 or younger. The women were diagnosed with ductal carcinoma in situ from
1994 to 2003. All underwent standard breast conservation surgery followed by
radiation. Median follow-up was 7.8 years.
Kong said there were 96 recurrences of both in situ and invasive breast cancers in the cohort (15.4%). Five-year OS
was excellent and not different between groups at 97% to 99%.
However, younger women had lower actuarial recurrence-free survival at
five and 10 years. Five-year recurrence-free survival was 84% for women younger
than 44 compared with 90% for those 45 to 50. by Jason Harris
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