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DCIS Margins and Genomic Profiles—Refresh Not Rehash!

Дата публикации: 01-09-2026 00:00:00

Optimizing local control in ductal carcinoma in situ (DCIS) is important because half of local failures are invasive with an antecedent risk of death. Margin width and adjuvant therapy have been a focus of investigation for many years as modifiable factors impacting local failure. Six large prospective trials (including National Surgical Adjuvant Breast and Bowel Project [NSABP] B-35) have investigated the role of adjuvant radiation and/or endocrine therapy; however, none addressed margin width. Therefore, I commend Wapnir et al for analyzing the margin width data from the NSABP B-35 trial to fill a gap in evidence pertaining to the ever-vexing problem of defining adequate margins in DCIS. The authors found a marginal, albeit statistically significant, difference in 10-year cumulative unadjusted local failure rate for both 1-mm and 2-mm discriminant thresholds; as expected, in models adjusting for other clinical factors, margin width was not a significant predictor of local recurrence.

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