Q) IN RTOG trial for ductal carcinoma in situ (DCIS) favourable tumor was defined as
a) <3,5 cm in size and 2mm free resection margin
b) <2.5 cm and 2mm margin
c) <3 cm size and 3 mm margin
d) <2.5 cm size and 3 mm margin
Answer - Free answers to surgery mcqs
d
Ductal carcinoma in situ is a pre invasive state in which the cancer cells have not breached the epithelial membrane. It can develop into cancer in 20%.
Simple mastectomy is the standard of care but many centers now consider it over treatment.
Van Nuys system uses
- Age of the patient
- type of DCIS
- presence of microcalcification
- Size
- resection margin
On mammography this is seen as clustered clustered calcification
Treatment options are
- Mastectomy
- Breast conserving therapy (Lumpectomy +radiation and hormonal)
More recently, Eastern Cooperative Oncology Group investigators reported the frst result of a relatively large prospective single-arm study of surgery with negative margins of at least 3 mm without radiation therapy for patients with favorable subsets of DCIS.
Patients with low-grade or intermediate-grade DCIS measuring 2.5 cm or smaller had a 5-year rate of ipsilateral breast recurrence of only 6.1%. In contrast, patients with high-grade disease had a much higher 5-year ipsilateral breast recurrence rate of 15.3%.
REF : Sabiston 853
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334775/