A 45 years old female presented with a history of pain!less breast lump of size 6 x 5 cm in left upper quadrant with no axillary lymph nodes. A true-cut biopsy was suggestive of ductal carcinoma in situ. She undergoes surgery with resection of all tumor tissue with adequate margins and postoperative HPE showing DCIS with high grade necrosis with 4 mm clearance on margins. Which of the following is needed?
Adjuvant chemotherapy
Adjuvant chemoradiotherapy
Adjuvant radiotherapy
No additional treatment
Answer- C. Adjuvant radiotherapyIn this case, patient is 45 years old (Score 2) with size 5 cm (Score 3), margin of 4 mm (Score 2), necrotic features withouthigh grade (Score 2), the total score is 9. Usually for score 7-9, if local excision is done radiotherapy should be given,If simple mastectomy is done, there is no need of adjuvant trcatment In this patient next best step would be adjuvant radiotherapy.DCIS is predominantly seen in the female breast (accounts for 5% of male breast cancers)DCIS carries a high risk for progression to an invasive cancer.DCIS is classified on the basis of nuclear grade & presence of necrosis