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DCIS Managed with BCS: Whole-Breast XRT vs. Partial Breast XRT

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Ductal Carcinoma In Situ and Microinvasive/Borderline Breast Cancer

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Abstract

Breast-conserving therapy (BCT) consisting of lumpectomy and adjuvant radiotherapy represents a standard of care in the management of ductal carcinoma in situ (DCIS). Over the past few decades, several randomized trials have demonstrated a 50 % reduction in the risk of local recurrence with adjuvant radiotherapy and recent prospective studies demonstrate higher rates of local recurrence with the omission of radiotherapy even in “low-risk” patients. As such, adjuvant radiotherapy remains an important component of BCT in women with DCIS.

In all of the trials mentioned above, whole-breast irradiation (WBI) has been the radiotherapy technique utilized to achieve the observed results. However, accelerated partial breast irradiation (APBI) represents an alternative to WBI. APBI shortens treatment duration to 1 week or less and offers patients several options to choose from including invasive and noninvasive techniques. While limited randomized data are available comparing WBI and APBI in the setting of DCIS, there is a growing body of literature supporting the clinical efficacy of APBI in patients with DCIS. Further, toxicity profiles with APBI have been shown to be comparable or improved to those seen with WBI. Based on these findings, recent evidence-based guidelines have included DCIS as acceptable for off-protocol utilization of APBI. With the future publication of several randomized trials, further data will emerge in order to better define which subsets of patients with DCIS are most suitable for treatment with APBI or WBI.

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Summa Health System/Northeast Ohio Medical University, 161N. Forge, Suite G90, 44304, Akron, OH, USA

    Chirag Shah MD

  2. Department of Radiation Oncology, Michigan Healthcare Professionals/21st Century Oncology, 28595 Orchard Lake Road, 48334, Farmington Hills, MI, USA

    Frank A. Vicini MD FACR

Authors
  1. Chirag Shah MD
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  2. Frank A. Vicini MD FACR
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Correspondence to Frank A. Vicini MD FACR .

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Editors and Affiliations

  1. Comprehensive Cancer Center, University of Michigan Health System, Ann Arbor, Michigan, USA

    Lisa A. Newman

  2. Comprehensive Cancer Center, University of Michigan Health System, Ann Arbor, Michigan, USA

    Jessica M. Bensenhaver

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Shah, C., Vicini, F. (2015). DCIS Managed with BCS: Whole-Breast XRT vs. Partial Breast XRT. In: Newman, L., Bensenhaver, J. (eds) Ductal Carcinoma In Situ and Microinvasive/Borderline Breast Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2035-8_9

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  • DOI: https://doi.org/10.1007/978-1-4939-2035-8_9

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