Radiotherapy for screen-detected ductal carcinoma in situ: indications and utilization in the United Kingdom – findings from the Sloane Project

There is an increasing use of wide local excision (WLE) in preference to mastectomy as the definitive surgical therapy. A number of randomised control trials (RCTs) have confirmed that postoperative whole-breast breast irradiation (RT) following WLE of DCIS reduces the risk of in situ and invasive recurrence. Available RCTs do not readily allow the identification of patients who would benefit most from RT, or conversely do not require RT.

Of 870 patients who underwent WLE for DCIS, 453 were referred for RT. The use of RT following WLE was correlated with pathological characteristics and margin status. The use of RT varied with tumour size, nuclear grade and the presence of necrosis, but not with margin size. There was a good correlation with Van Nuys Score, supporting the use of this scoring system in routine practice to predict the potential benefits of referral for RT.

Table 1