Oncology · Surgery ·
Negative DCIS Margins Under 2 mm Not Linked to Higher Recurrence Overall
A retrospective cohort study of 11,156 women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery found no significant difference in ipsilateral recurrence between negative margins under 2 mm and margins of at least 2 mm. The association differed in a subgroup younger than 50 years; median follow-up was 66.6 months.
- Cohort included 11,156 women with DCIS.
- Four percent had ipsilateral recurrence during follow-up.
- No overall recurrence difference by negative margin width.
- A difference was observed in patients younger than 50.
Researchers analyzed a multicenter cohort of women diagnosed with DCIS between 2008 and 2015 who underwent breast-conserving surgery. The retrospective observational study included 11,156 patients, with final margins classified as positive, 0.01–0.9 mm, 1.0–1.9 mm, or at least 2 mm. The primary outcome was ipsilateral recurrence. Overall, 72.2% received radiotherapy after surgery and 27.8% had surgery alone; median age was 61 years and median follow-up was 66.6 months.
During follow-up, 445 patients (4%) had a recurrence. After multivariable adjustment, recurrence risk did not differ significantly between the negative-margin groups, whether patients received radiotherapy or not. Among subgroup analyses by age and other clinical and treatment characteristics, only patients younger than 50 years showed a significant difference between narrow (0.01–1.9 mm) and wider (at least 2 mm) margins. The retrospective findings do not establish that margin width can be disregarded in individual care; the age subgroup result warrants attention, and the study does not report randomized comparisons of re-excision strategies.
In practice
For women with DCIS treated with breast-conserving surgery, this retrospective cohort found no significant overall difference in ipsilateral recurrence between negative margins below 2 mm and margins of at least 2 mm, including among patients treated with or without radiotherapy. A significant difference between narrow and wider margins was seen in the subgroup younger than 50 years. These findings may inform discussion of margin width, but they do not establish a change to re-excision practice: the study was observational, follow-up was a median of 66.6 months, and the age-specific result comes from subgroup analysis.
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Journal of Clinical Oncology: Patient-Level Evaluation of Optimal Margin Width for Lumpectomy in Ductal Carcinoma In Situ: An Analysis of Patients in the National Cancer Database Special Study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.