Younger DCIS Patients Face Higher Recurrence Risk After Breast-Conserving Surgery

Following breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS), younger women face a higher risk than older patients for recurrence of both DCIS and invasive carcinomas, reported Kimberly Van Zee, MD, FACS, a surgical oncologist at Memorial Sloan Kettering Cancer Center in New York, at the 33rd Annual Miami Breast Cancer Conference, held March 10–13 in Miami Beach, Florida.

“Young age (younger than age 40 years at diagnosis) is a highly significant risk factor for any recurrence after BCS for DCIS,” Dr. Van Zee said, during her review of the available research.

Ten-year recurrence rates of 27.3% for women younger than 40 vs 7.5% among women 80 or older,” she said. “This age effect persists even after adjusting for other factors that vary by age.”

“Older age was associated with lower recurrence in both cohorts that did and did not receive radiation,” she added.

Women younger than 40 years face a seven-fold higher risk of invasive recurrence than do women age 80 or older at the time of DCIS diagnosis.

“In women younger than 40 years, invasive recurrences are more likely than DCIS recurrences,” she noted, whereas DCIS recurrences are more common in women age 40 or older.

“Age is an important factor that should be considered in weighing the various treatment options, including surgical options and the use of adjuvant radiation and endocrine therapies,” Dr. Van Zee said. “Women age 80 or older are at low risk of recurrence, even in the absence of adjuvant therapies.”