• Radiotherapy (RT) after breast-conserving surgery (BCS):
    • Is a standard treatment option for the management of DCIS
  • Multifocal disease:
    • Two or more foci contained within a limited area and usually the same quadrant of the breast:
      • Is not necessarily a contraindication to BCT
    • The detrimental effect of multifocality seen in one study:
      • Was limited to women who did not receive radiotherapy:
    • Among women treated with breast-conserving surgery plus radiation:
      • There was no difference in 10-year local recurrence-free survival:
        • 80% v 87%; P = .35
  • Patients requiring mastectomy for high grade DCIS with comedy necrosis:
    • May benefit from sentinel node biopsy
  • In the NSABP-B24 study:
    • Only patients with hormone receptor positive DCIS benefited from adjuvant tamoxifen


1. Rakovitch E, Pignol JP, Hanna W, Narod S, Spayne J, Nofech-Mozes S, et al. Significance of multifocality in ductal carcinoma in situ: outcomes of women treated with breast-conserving therapy. J Clin Oncol. 2007;25(35):5591-5596.

2. Allred DC, Anderson SJ, Paik S, Wickerham DL, Nagtegaal ID, Swain SM, et al. Adjuvant tamoxifen reduces subsequent breast cancer in women with estrogen receptor-positive ductal carcinoma in situ: a study based on NSABP protocol B-24. J Clin Oncol. 2012;30(12):1268-1273.

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