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Purpose <p>Breast-conserving surgery for larger ductal carcinoma in situ (DCIS) remains limited. We compare the attempted use and success rates of lumpectomy surgery in patients with DCIS measuring ≥ 4&#xa0;cm versus &lt; 4&#xa0;cm.</p> Methods <p>A retrospective review was conducted using the institutional tumor registry to identify cases of pure DCIS that were surgically treated from 2015 to 2022. Clinical-pathological data were abstracted from electronic medical records. Pathologic tumor size on initial surgery was used to define the two cohorts. Comparisons of variables were made using Chi-square and ANOVA tests.</p> Results <p>A total of 669 patients, 84% (562) with tumors measuring &lt; 4&#xa0;cm and 16% (107) ≥ 4&#xa0;cm were identified. Lumpectomy was the initial surgery performed for 89% of women with lesions measuring &lt; 4&#xa0;cm on preoperative imaging studies compared to 64% of those ≥ 4&#xa0;cm. Overall, 461 (92.9%) of 496 in the &lt; 4&#xa0;cm succeeded at lumpectomy compared to 36 (56.3%) of 64 in the ≥ 4&#xa0;cm group. Re-excision lumpectomies or mastectomy were performed in 27% and 44% of the &lt; 4&#xa0;cm and ≥ 4&#xa0;cm subgroups. Lumpectomy was achieved for 70% of women with tumors in the 4 to 5.9&#xa0;cm range compared to 33% in the 6–7.9&#xa0;cm and the ≥ 8&#xa0;cm groups. There were no local recurrences in the ≥ 4&#xa0;cm group at an average of 4.4&#xa0;years follow-up.</p> Conclusion <p>Lumpectomy is a viable option for many patients with DCIS ≥ 4&#xa0;cm, especially those measuring &lt; 6&#xa0;cm, though repeat re-excisions may be required after initial attempt.</p>

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Lumpectomy surgery for large ductal carcinoma in situ

  • 期刊论文

  • 发表日期：

    2025年2月10日

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  • Daniela Bresciani Padilla,
  • Jacqueline Tsai,
  • Amanda Sutherland Beck,
  • Irene L. Wapnir

摘要

Purpose

Breast-conserving surgery for larger ductal carcinoma in situ (DCIS) remains limited. We compare the attempted use and success rates of lumpectomy surgery in patients with DCIS measuring ≥ 4 cm versus < 4 cm.

Methods

A retrospective review was conducted using the institutional tumor registry to identify cases of pure DCIS that were surgically treated from 2015 to 2022. Clinical-pathological data were abstracted from electronic medical records. Pathologic tumor size on initial surgery was used to define the two cohorts. Comparisons of variables were made using Chi-square and ANOVA tests.

Results

A total of 669 patients, 84% (562) with tumors measuring < 4 cm and 16% (107) ≥ 4 cm were identified. Lumpectomy was the initial surgery performed for 89% of women with lesions measuring < 4 cm on preoperative imaging studies compared to 64% of those ≥ 4 cm. Overall, 461 (92.9%) of 496 in the < 4 cm succeeded at lumpectomy compared to 36 (56.3%) of 64 in the ≥ 4 cm group. Re-excision lumpectomies or mastectomy were performed in 27% and 44% of the < 4 cm and ≥ 4 cm subgroups. Lumpectomy was achieved for 70% of women with tumors in the 4 to 5.9 cm range compared to 33% in the 6–7.9 cm and the ≥ 8 cm groups. There were no local recurrences in the ≥ 4 cm group at an average of 4.4 years follow-up.

Conclusion

Lumpectomy is a viable option for many patients with DCIS ≥ 4 cm, especially those measuring < 6 cm, though repeat re-excisions may be required after initial attempt.