1. ¹Department of Clinical Oncology, Cookridge Hospital, Hospital Lane, Leeds, LS16 6QB, UK
2. ²West Midlands Cancer Intelligence Unit, Public Health Building, The University of Birmingham, Birmingham, B15 2TT, UK
3. ³Ninewells Hospital, Dundee, DD1 9SY, UK
4. ⁴Bolton Breast Unit, Royal Bolton Hospital, Minerva Road, Farnworth, Bolton, BL4 0JR, UK

Correspondence: Dr D Dodwell, E-mail: david.dodwell@leedsth.nhs.uk

Received 17 April 2007; Revised 4 July 2007; Accepted 20 July 2007.

Abstract

Use of radiotherapy (RT) after breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS) varies according to country, precedent and prejudice. Results from a preliminary analysis of the data available within the UK Sloane Project can be appreciated in the context of the uncertainty concerning the selection of adjuvant RT following BCS for DCIS. There was a marked geographical variation in the use of RT within the United Kingdom. However, overall, patients with DCIS treated with BCS were significantly more likely to have RT planned (and given) if they had large (15 mm), intermediate or high-grade tumours or if central comedo-type necrosis was present. Unexpectedly, margin width did not appear to have a significant effect on the decision-making process. However, the Van Nuys Prognostic Index did significantly affect the chances of getting planned RT in the univariate analysis, suggesting that clinicians may be starting to use this scoring system in routine practice to assist in decision making.