Do you recommend hypofractionated/Canadian fractionation for in-situ ductal cancer?

The same pretzel logic used to deny hypo fractionation to patients with DCIS was used in the 80's to deny them breast conservation. It is not only reasonable to extrapolate the data from over 7000 patients with early stage invasive breast cancer on the British and Canadian trials, it is necessary fo...

While patients with DCIS were not included in the original randomized trials comparing hypofractionated WBI to conventionally fractionated WBI, it certainly seems reasonable to extrapolate these trials to women with DCIS, and it is increasingly my practice to do so. I typically will share with patie...

The new ASTRO guideline on whole breast fractionation recently published in Practical Radiation Oncology (PRO) concluded that hypofractionation may be offered as an alternative to conventional fractionation in patients with DCIS. There was 86% consensus on this point, based on a moderate level of ev...

In addition to above, also see:

Constantine, C (NYU) Feasibility of Accelerated Whole Breast Radiation in the Treatment of DCIS. Clinical Breast Cancer. June 2008, p. 269.

Hathout, L (Canada) Hypofractionated RT for Breast DCIS. IJROBP. vol 87(5), 2013.

We as a specialty have been treating patients who had invasive cancer with a component of DCIS whether it was EIC or not using hypofractionation in all of those trials, both on protocol and off protocol and there has been NO difference. DCIS is thus, no different, radiobiologically from invasive dis...