Young age is not associated with increased local recurrence for DCIS treated by breast-conserving surgery and radiation

Background: We report local recurrence (LR) after breast-conserving surgery and radiation (BCS+RT) for ductal carcinoma in situ (DCIS) to determine outcomes for patients aged ≤40 years compared with older women. Methods: The study included 440 women with DCIS treated from 1978 to 2007. All patients received whole-breast radiotherapy with a boost in 95% of cases. Demographics, characteristics, surgical, and adjuvant treatments were analyzed for an effect on LR. Results: Median age was 56.5 years with 24 patients aged ≤40. Median DCIS size was 0.8 cm. Re-excision was required in 62% of patients, and in 75% of those aged ≤40. Tamoxifen was used in 22%, but only one patient aged ≤40. Median follow-up was 6.8 years. Actuarial LR was 7% (95% confidence interval of 4-11%) at 10 years and 8% (5-14%) at 15 years. There was no difference in LR by age (P=0.76). Conclusions: The long-term risk of LR after BCS+RT for DCIS is low, even in patients ≤40 years. This may be due to patient selection for small size, high utilization of re-excision, and radiation boost. Young age may be a smaller contributor to LR risk in DCIS than previously suggested.