To the Editor. —The paper that appeared in the April 1991 issue of the Archives by Silverstein et al1 is a well researched study that sheds light on the natural behavior of intraductal carcinoma. Based on the 7% local recurrence rate, the authors cast a doubt on the effectiveness of lumpectomy and radiation therapy for ductal carcinoma in situ (DCIS). This is unfortunate! The risk of ipsilateral failure is much lower than the risk of a new tumor in the contralateral breast. It is heartening that none of the patients in the series had, and the authors do not recommend, bilateral mastectomy for DCIS.
The 7% incidence of local recurrence in patients treated with lumpectomy and radiation therapy is significantly lower than the reported incidence of local recurrence in infiltrating ductal carcinoma treated in a similar manner. Hence, there is no basis for the authors' comment that "Intraductal carcinomas
LAWRENCE G. Evaluation of Treatment Options for Ductal Carcinoma In Situ of the Breast. Arch Surg. 1991;126(12):1541. doi:10.1001/archsurg.1991.01410360119019