Radical surgery and conservative treatment of ductal carcinoma in situ of the breast

70 cases of strictly intraductal breast carcinoma were treated from January 1975 to December 1987. 34 patients underwent radical modified mastectomy, and 36 patients had local excision (2), lumpectomy (26) or quadrantectomy (8), with a complementary irradiation in 34/36 cases (with boost in 32). The main histological subtype is comedocarcinoma (25/70). One local relapse (3%) is noted in radical surgery group at 55 months. 3 local relapses (9%) are noted in conservative treatment group, respectively at 27, 48 and 52 months. The obvious factor influencing the local recurrence is the inefficient surgical excision. Since breast screening programs may lead to early duct carcinoma in situ identification, our results suggest that appropriate conservative surgery associated to radiation therapy could be an adequate alternative to mastectomy in the treatment of this in situ lesion.