Re-excision in Ductal Carcinoma In Situ Is Not Associated With Improved Local Control: A Retrospective Cohort Study

Purpose Ductal carcinoma in situ (DCIS) is a non-invasive precursor of invasive breast cancer and is primarily treated surgically. Re-excision is commonly performed to achieve clear margins; however, its impact on local recurrence remains controversial. This study evaluated whether re-excision influences the risk of ipsilateral breast tumor recurrence in patients with DCIS. Methods In this retrospective single-center cohort study, all patients treated for DCIS at the University Hospital Münster between 2003 and 2015 were included. Clinical and pathological parameters including age, menopausal status, tumor size, nuclear grade, re-excision and adjuvant radiotherapy were analyzed. Follow-up data were obtained from the German cancer registry. The association between re-excision and local recurrence was analyzed using log-rank testing, and multivariate Cox regression was performed to identify independent risk factors. Results A total of 425 patients were treated for DCIS between 2003 and 2015, with follow-up data available for 247 patients (mean follow-up: 4.4 years). Re-excision was performed in 119 patients (48.2%). Local recurrence occurred in 8 patients (6.7%) with re-excision and in 9 patients (7.1%) without. The 5-year local recurrence rate was 2.9% with re-excision versus 6.0% without (p = 0.33). Multivariate analysis identified younger age (p = 0.03) and premenopausal status (p = 0.02) as significant risk factors, while adjuvant radiotherapy showed a protective effect (p = 0.01). Conclusion Re-excision was not associated with a significantly different risk of local recurrence. Younger age and premenopausal status were associated with increased recurrence risk, whereas adjuvant radiotherapy was associated with improved local control. Micro Abstract Background: The benefit of re-excision for close margins in DCIS remains debated. Methods: Retrospective cohort study of 425 patients; recurrence analyses based on 247 patients with follow-up. Results: Re-excision showed no statistically significant reduction in local recurrence. Premenopausal status and radiotherapy were the key determinants of recurrence risk. Conclusion: Local recurrence in DCIS appears driven by tumor biology and patient characteristics rather than surgical re-intervention.