The rate of recurrence after treatment for pure DCIS has been recognized range from 5-20%. Approximately half of these patients are invasive and less than 1% is distant metastasis. The aims of our study was to identify pattern of recurrence, clinicopathological makers of recurrence in King Chulalongkorn Memorial Hospital.
One hundred and seventy- four patients who diagnosed with pure DCIS between 1998 and 2016 at King Chulalongkorn Memorial Hospital were reviewed retrospectively. The clinical and pathologic characteristics of DCIS patients including pattern of locoregional recurrence and distant metastasis were analyzed.
In initial analysis, 17 from 174 patients (9.8%) with initially pure DCIS were diagnosed with recurrent disease. 15 out of 17 (88.2%) patients were loco-regional recurrence. Distant metastasis was rarely reported in 2 out of 17 patients (11.8%). For recurrent subgroup, the median age was 47.5 years (33-66) and 50% had tumor size more than 1 centimeter. 75% had histologic grade I-II, none of patients had DCIS with comedonecrosis, 92% had DCIS with positive estrogen receptor and 61% had negative margin, but approximately 30% had closed margin. In term of treatment, 58.8% underwent wide excision, 21.1% received postoperative radiation, 28.6% received 5 years tamoxifen for prevention. The median time of overall recurrence was 103 months (11-205). Only one patient had died of disease. Disease free survival and overall survival will be further analyzed.
Pattern of recurrence after diagnosis of pure DCIS is mostly loco-regional recurrence and rarely distant metastasis. Further study of clinicopathological predictors is essential for early prevention and improved the treatment outcome of pure DCIS patients.
Medical Oncology Unit, Internal Medicine Department, King Chulalongkorn Memorial Hospital
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All authors have declared no conflicts of interest.