Do you recommend omitting radiation therapy in young women with favorable DCIS?

If someone can get a screening mammogram, diagnostic mammogram, image-guided biopsy, segmental mastectomy, entertain a conversation about 5 years of ET, they can most certainly handle 5-15 days of PBI where the grade 0 toxicity rate is exceedingly high. Whole breast RT with the Whelan regimen is als...

As you know, young women were eligible for RTOG 9804 (criteria: >26 years old). And yet, the median age in this trial was 58 with 51 being the lower bound of the inter-quartile range. So you are right to take pause when seeing young women with DCIS in clinic who would otherwise meet RTOG 9804 criter...

I often bring up the long-term results of ECOG 5194 at the tumor board and with my patients when this issue comes up. This study omitted radiation for what was perceived to be favorable risk DCIS (up to 2.5 cm for low/intermediate grade, 1 cm for high grade, minimum 3 mm margins). Even though the st...

The risk of recurrence is low and goes up a bit with extended follow up. The answer to this question is an informed and collective decision with the patient as her perspective and priority would be an important component of the final decision. (Risk of recurrence, small absolute benefit, inconvenien...

At this time, I do not routinely recommend omitting adjuvant radiation in young women with DCIS. As noted above, the ECOG 5194 studies continue to demonstrate an increase in recurrences, including invasive recurrences, with no plateau noted. Additionally, we know that invasive ipsilateral recurrence...