Factors associated with decision to pursue mastectomy and breast reconstruction for treatment of ductal carcinoma in situ of the breast

Am J Surg. 2013 Nov;206(5):682-5. doi: 10.1016/j.amjsurg.2013.07.001. Epub 2013 Sep 4.

Abstract

Background: Factors influencing the treatment of ductal carcinoma in situ with mastectomy and reconstruction are poorly understood.

Methods: A retrospective cohort study of 196 patients presenting to one institution was performed.

Results: Forty-seven patients (24.0%) were treated with mastectomy, while 149 (76.0%) underwent breast-conserving surgery. Of the mastectomy patients, 28 (59.6%) elected for reconstruction. On bivariate analysis, patients who opted for mastectomy were younger than those treated with breast-conserving surgery (median age, 51.8 vs. 56.5 years; P = .017) and had higher grade tumors (50.0% vs. 34.6% grade 3, P = .009). Among patients treated with mastectomy, those who opted for reconstruction were younger than those forgoing reconstruction (49.4 vs. 56.9 years, P = .024). Race, ductal carcinoma in situ tumor size, and histologic subtype were not associated with the decision to pursue mastectomy or reconstruction (P > .05 for all).

Conclusions: In patients with ductal carcinoma in situ, the decision to pursue mastectomy and reconstruction appears to be driven by younger patient age and higher tumor grade.

Keywords: Breast reconstruction; Ductal carcinoma in situ; Mastectomy.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Carcinoma in Situ / pathology
  • Carcinoma in Situ / surgery*
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / surgery*
  • Cohort Studies
  • Decision Making*
  • Female
  • Humans
  • Mammaplasty* / methods
  • Mastectomy*
  • Middle Aged
  • Neoplasm Grading
  • Retrospective Studies