Association of Radiotherapy Boost for Ductal Carcinoma In Situ With Local Control After Whole-Breast Radiotherapy

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Abstract
The incidence of ductal carcinoma in situ (DCIS) has steadily increased with widespread screening and advances in breast imaging.1 Despite its excellent prognosis relative to invasive breast cancer, DCIS remains a heterogeneous disease for which optimal treatment management is commonly debated. The use of whole-breast radiotherapy (WBRT) for DCIS is supported by level 1 data from randomized trials that consistently demonstrate an approximately 50% reduction in relative risk for ipsilateral breast tumor recurrence (IBTR), with very limited in-breast treatment failures with long-term follow-up.2-5 Because the benefit of WBRT is apparent in all DCIS subgroups, consistently defining subsets in which RT can be omitted remains a challenge.2-5 More recently, the use of WBRT in patients with higher-risk DCIS has been suggested to be associated with a statistically significant improvement in survival.6

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