Higher local recurrence after skin-sparing than simple mastectomy for DCIS

Prof Bundred talks to ecancertv at SABCS 2015 about a retrospective study comparing local recurrence rates after simple mastectomy or skin-sparing mastectomy for ductal carcinoma in situ (DCIS).

Traditionally DCIS has been treated by simple mastectomy. This is associated with a low rate of local breast cancer recurrence, but there have been recent data suggesting that local recurrence rates are increasing. Skin-sparing mastectomy has emerged as an alternative as it results in a better cosmetic outcome, but there are few data looking at local recurrence.

Local recurrence at 10-years was 0% in women who had a simple mastectomy and 5.6% in those who had skin-sparing mastectomy. This shows that you have to be very careful that the surgical margins are clear after the latter procedure, Dr Bundred observes. Post-reconstruction mammograms may be worth considering if skin-sparing mastectomies are performed and then re-excision or adjuvant radiotherapy if the surgical margins are close in ER-negative tumours.