Patient Care and Research

ASTRO guideline on BCS with WBI in DCIS

Online – June 2016
Print – September 2016

This collaborative guideline focuses on several elements of optimal margin negative margin width for ductal carcinoma in situ treated with breast-conserving surgery and whole breast irradiation. It defines positive margins and provides recommendations on negative margin width. The guideline then discusses the impact on negative margin width of treatment with excision alone or with endocrine therapy; patient and tumor features; and DCIS in presence of invasive breast cancer. The document also looks at the role of margin width in choice of technique, fractionation and boost dose for whole breast irradiation. 

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Quick Reference

  • Determination of optimal margin width to minimize risk of ipsilateral breast tumor recurrence
  • Whole-breast radiation therapy (WBRT) in combination with excision
  • Excision alone
  • Endocrine therapy
  • Consideration of unfavorable risk factors in determining margin width
  • Choice of WBFT delivery technique, fractionation and boost dose
  • Considerations for DCIS with microinvasion when determining optimal margin width

Radiation Therapy for Breast Cancer
Summary Recommendation Table
Summary Presentation

Author Society
American Society for Radiation Oncology
American Society of Clinical Oncology
Society of Surgical Oncology

Previous version

American Society of Breast Surgeons

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