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Association of radiation therapy plus lumpectomy in reduced risk of dying in women with DCIS

Lumpectomy plus radiation was associated with a small clinical benefit in reduced risk of breast cancer death compared with lumpectomy or mastectomy alone in women with ductal carcinoma in situ (DCIS), a noninvasive early form of breast cancer.

Patients with DCIS are often treated with radiation after lumpectomy, although it has remained unclear whether this can reduce the risk of dying from breast cancer.

This study compared lumpectomy plus radiation vs. lumpectomy alone, lumpectomy vs. mastectomy, and lumpectomy plus radiation vs. mastectomy for more than 140,000 U.S. women who had DCIS between 1998 and 2014.

Results are published in the journal JAMA Network Open.

This was an observational study.

Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

A small improvement in breast cancer survival was associated with radiation plus lumpectomy for DCIS.

The absolute risk reduction was 0.27 percent, making it necessary to treat 370 women to save one life.

Patients who had lumpectomy plus radiation had more local recurrences than the mastectomy patients but had fewer deaths.

Some data were missing; investigators didn't have information on tamoxifen use; treatments in the study population weren't randomly assigned; and the possibility remains that the decision to undergo radiotherapy was associated with other favorable prognostic factors.

Source: JAMA

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