Formalised data collection on patient-reported outcomes (PROs) following treatment of early-stage breast cancer is now embedded in oncoplastic and reconstructive breast surgery. Most PRO studies to date pertain to invasive disease, which is likely to require adjuvant treatments that can adversely influence health-related quality of life (HRQOL). There is a dearth of information specifically relating to PROs for ductal carcinoma in situ, which has an exceptionally low mortality (3% at 20 years). There is no demonstrable survival benefit from the addition of breast irradiation, endocrine therapy, or a combination of these treatments, to lumpectomy. Breast irradiation proportionately halves the risk of ipsilateral breast recurrence, with an absolute reduction of 15·2% (p<0·00001) at 10 years reported in a meta-analysis. A low event rate might preclude any reduction in mortality from breast cancer or all-cause mortality. ^,  Any benefits of adjuvant therapies on local control must be balanced against potentially harmful side-effects plus patient inconvenience and cost. Contemporary guidelines recommend radiotherapy for most patients with non-low-risk ductal carcinoma in situ, but boost criteria remain uncertain. ^{,  ,}  Historically, trials of conservation therapy for ductal carcinoma in situ used a conventional radiotherapy schedule (50 Gy, 25 fractions, over 5 weeks) with a discretionary tumour bed boost for 5% and 9% of patients in two trials (based on factors such as young age and margin status).

中文翻译：

---

非低风险导管原位癌女性保乳手术后的生活质量。

关于早期乳腺癌治疗后患者报告结果（PRO）的正式数据收集现已嵌入到肿瘤整形和重建性乳腺癌手术中。迄今为止，大多数PRO研究都与浸润性疾病有关，它可能需要辅助治疗，可能会对健康相关的生活质量（HRQOL）产生不利影响。缺乏关于原位导管癌PROs的专门信息，其死亡率极低（20岁时为3％）。在乳房切除术中增加乳房照射，内分泌治疗或这些治疗的组合并没有明显的生存获益。荟萃分析显示，乳房放疗可将同侧乳房复发的风险降低一半，在10年时绝对降低15·2％（p <0·00001）。^， 辅助疗法对局部控制的任何好处都必须与潜在的有害副作用以及给患者带来的不便和费用保持平衡。当代指南建议对大多数非低危导管原位癌患者进行放射治疗，但加强标准仍不确定。^{，  ，} 从历史上看，保护治疗原位导管癌的临床试验中使用的常规放疗时间表（50戈瑞，25级分，经5周）与一个任意肿瘤床升压为5％和9％的患者在两个试验（基于因素例如年龄和边缘状况）。