Wide Excision Alone as Treatment for Ductal Carcinoma in Situ of The Breast

Ductal Carcinoma in Situ of the Breast Clinical Trial

Official title:

Wide Excision Alone for DCIS-Grades 1 and 2

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT00165256
• Other study ID #: 94-151
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: May 1995
• Est. completion date: November 2024

Study information

• Verified date: December 2023
• Source: Dana-Farber Cancer Institute
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine if wide excision (surgical removal) alone is adequate treatment for small, grade 1 or 2 ductal carcinoma in situ (DCIS) of the breast.

Description:

• Patients with DCIS are usually treated with the combination of breast-conserving surgery and radiation therapy or breast-conserving surgery alone. The purpose of this study is to evaluate whether localized low- or intermediate-grade DCIS, diagnosed with modern mammography and careful pathologic evaluation, could be treated with wide excision alone (omission of radiation therapy) and result in acceptably low local recurrence rates.

• Follow-up consists of physical examinations at least every 6 months by the surgeon or radiation oncologist. Mammograms of the affected breast will be obtained every 6 months for 5 years and then annually. Mammograms of the unaffected breast will be performed annually.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 158
• Est. completion date: November 2024
• Est. primary completion date: July 2002
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients must have high quality mammogram including magnification views of the area containing suspicious calcifications.

• A specimen radiograph is required. If the specimen radiograph does not assure removal of all suspicious microcalcifications, a post-operative mammogram showing removal of all suspicious calcifications is required.

• The clinical extent of DCIS must be less than or equal to 2.5 cm.

• Grade 1 or 2 DCIS; patients with lobular carcinoma-in-situ (LCIS) in addition to DCIS in the breast are eligible. Negative margins are not required on the LCIS.

• Patients must undergo a wide excision. A re-excision after the initial biopsy might be needed. Complete resection of the area of DCIS with a histologic margin of at least 1 cm must be achieved.

• Patients must be enrolled on this protocol within 3 months of the last surgical procedure.

Exclusion Criteria:

• Patients with invasive carcinoma including microinvasive disease

• Carcinoma found in the sampled lymph nodes if axillary dissection is done

• Patients with nipple discharge

• Patients with adjuvant chemotherapy or Tamoxifen

• Patients with a history of prior malignancies other than squamous or basal cell carcinoma of the skin, or carcinoma in situ of the cervix.

• Patients with a history of ipsilateral or contralateral breast carcinoma or DCIS or simultaneous bilateral DCIS.

Related Conditions & MeSH terms

• Breast Carcinoma In Situ
• Carcinoma
• Carcinoma in Situ
• Carcinoma, Ductal
• Carcinoma, Intraductal, Noninfiltrating
• Ductal Carcinoma in Situ of the Breast

Intervention

Other:
• Observation
Wide excision of DCIS and a minimum of 1cm histologically negative margin of breast tissue

Locations

Country	Name	City	State
United States	Dana-Farber Cancer Institute	Boston	Massachusetts
United States	Massachusetts General Hospital	Boston	Massachusetts

Sponsors (4)

Lead Sponsor	Collaborator
Dana-Farber Cancer Institute	Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Massachusetts General Hospital

Country where clinical trial is conducted

United States, 

References & Publications (2)

Wong JS, Chen YH, Gadd MA, Gelman R, Lester SC, Schnitt SJ, Sgroi DC, Silver BJ, Smith BL, Troyan SL, Harris JR. Eight-year update of a prospective study of wide excision alone for small low- or intermediate-grade ductal carcinoma in situ (DCIS). Breast C — View Citation

Wong JS, Kaelin CM, Troyan SL, Gadd MA, Gelman R, Lester SC, Schnitt SJ, Sgroi DC, Silver BJ, Harris JR, Smith BL. Prospective study of wide excision alone for ductal carcinoma in situ of the breast. J Clin Oncol. 2006 Mar 1;24(7):1031-6. doi: 10.1200/JCO — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	To determine if patients with DCIS can be effectively treated with wide excision alone.	Using information gathered from follow-up physical examinations and mammography to check for recurrence (DCIS or invasive carcinoma in the breast), DCIS patients treated with wide excision alone will be evaluated.	TBD-survivorship
Secondary	To explore whether patients with grade 2 DCIS have a higher breast recurrence than patients with grade 1 DCIS.	Using information gathered from follow-up physical examinations and mammography, the exploration of breast recurrences between grade 2 DCIS and grade 1 DCIS patients will be evaluated.	TBD-survivorship