[Conservative radiosurgical treatment in in situ ductal XXXX . Analysis of 86 cases].

@entity1 @entity3821 @entity440 @entity0 @entity66 @entity5 @entity3
OBJECTIVES: With effective screening programmes, the global incidence of @entity0 has risen to 15%, representing 20 to 30% of the mammographically detected T0 @entity5 . Prognosis is generally good in these @entity5 , but treatment has in the past, paradoxically, relied on extensive surgery. We report our experience with conservative radiosurgery performed in such cases from 1980 to 1990. METHODS: There were 86 @entity1 with a mean age of 52 years. Initial TNM classification was T0 = 57, T1 = 17, T2 = 9 and Tx = 3. All underwent limited surgery (quadrantectomy: 17; lumpectomy: 69) and 49 had axillary dissection. All received breast irradiation with scar boost (46-50 Gy + 10-14 Gy with classical fractionation). Thirty one postmenopausal @entity1 received adjuvant @entity440 . The quality of the resection was good in 77 cases, doubtful or incomplete in 9. In one case axillary nodal involvement was found. The histological subtype was clearly identified in 63 cases. With a median follow-up of 58 months, 3 local relapses occurred (3.4%), at 27, 48 and 52 months respectively. One was in situ and two invasive. All were clinical lesions (2 T1 and 1 T2); two had incomplete or doubtful excision and all received less than 60 Gy on the @entity5 bed. All had mastectomy. Two are alive and well but one developed multiple @entity3 . Five other @entity1 had subsequent surgery for suspicion of local relapse but all had benign disease. One developed @entity66 20 months later. Two @entity1 died subsequently due to a second @entity5 . CONCLUSION: These results confirm the importance of the excision quality and suggests a possible dose-effect in the control of @entity3821 by radiotherapy. The recent results of the B-17 NSBAP trial also conclude that the radiosurgical conservative treatment, for limited @entity3821 , is a reasonable alternative to mastectomy.
