Breast-Conserving Surgery and Whole-Breast Radiation Therapy With or Without Additional Radiation Therapy to the Tumor in Treating Women With Ductal Carcinoma in Situ (BONBIS)

NCT00907868 | Active Not Recruiting

• 4 other identifiers: CDR0000636007RECF0911VA-2008/252008-A00494-51
• Study Type: interventional
• Target: 2,004
• Locations: 1 country
• Sites: 1

Brief Summary

RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Giving radiation therapy after surgery may kill any tumor cells that remain after surgery. It is not yet known whether whole-breast radiation therapy is more effective when given with or without additional radiation therapy to the tumor in treating patients with ductal carcinoma in situ. PURPOSE: This randomized phase III trial is studying breast-conserving surgery followed by whole-breast radiation therapy to see how well it works when given with or without additional radiation therapy to the tumor in treating women with ductal carcinoma in situ.

Conditions

Breast Cancer

Keywords

ductal breast carcinoma in situ

Outcome Measures

Primary Outcomes (1)

• Time to recurrence

  up to 15 years of follow up

Study Arms (2)

Arm I

ACTIVE COMPARATOR

Patients undergo whole breast irradiation (WBI) once daily for 5 weeks (weekdays only).

Radiation: whole breast irradiation

Arm II

EXPERIMENTAL

Patients undergo WBI as in arm I and a radiation tumor bed boost once daily for 8 days (weekdays only).

Radiation: partial breast irradiation; Radiation: whole breast irradiation

Interventions

partial breast irradiation RADIATION

Patients undergo radiation tumor bed boost

Arm II

whole breast irradiation RADIATION

Patients undergo whole breast irradiation

Arm I; Arm II

Eligibility Criteria

• Age: 18 Years - 120 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

DISEASE CHARACTERISTICS: * Histologically confirmed ductal carcinoma in situ of the breast * No invasive component * No clinically palpable lymph node or presence of tumor cells in the sentinel lymph node (if done) * No local recurrence of a primary breast cancer * No multicentric or multifocal tumors not suitable for conservative surgery R0 with a margin ≥ 1 mm * Has undergone bilateral mammography within 6 months before randomization PATIENT CHARACTERISTICS: * ECOG performance status 0-2 * Life expectancy \> 5 years * Not pregnant * Available for long-term follow up * No history of in situ carcinoma in the contralateral breast * No history of another cancer except for basal cell carcinoma of the skin or carcinoma in situ of the cervix * No uncontrolled cardiac, renal, or pulmonary disease * No uncontrolled systemic disease (e.g., lupus erythematosus or scleroderma) * No HIV positivity * Affiliated with the social health system * No psychological, familial, sociological, or geographical situations that preclude compliance with study treatment and follow up PRIOR CONCURRENT THERAPY: * See Disease Characteristics * No concurrent participation in another therapeutic trial (participation in epidemiologic studies is allowed)

Contact the study team to discuss eligibility requirements. They can help determine if this study is right for you.

Sponsors & Collaborators

• Institut du Cancer de Montpellier - Val d'Aurelle: lead

Study Sites (1)

Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle

Montpellier, 34298, France

Location

Related Publications (19)

• Azria D, Gourgou S, Sozzi WJ, Zouhair A, Mirimanoff RO, Kramar A, Lemanski C, Dubois JB, Romieu G, Pelegrin A, Ozsahin M. Concomitant use of tamoxifen with radiotherapy enhances subcutaneous breast fibrosis in hypersensitive patients. Br J Cancer. 2004 Oct 4;91(7):1251-60. doi: 10.1038/sj.bjc.6602146.

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• EORTC Breast Cancer Cooperative Group; EORTC Radiotherapy Group; Bijker N, Meijnen P, Peterse JL, Bogaerts J, Van Hoorebeeck I, Julien JP, Gennaro M, Rouanet P, Avril A, Fentiman IS, Bartelink H, Rutgers EJ. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phase III trial 10853--a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. J Clin Oncol. 2006 Jul 20;24(21):3381-7. doi: 10.1200/JCO.2006.06.1366. Epub 2006 Jun 26.

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• Bijker N, Peterse JL, Duchateau L, Julien JP, Fentiman IS, Duval C, Di Palma S, Simony-Lafontaine J, de Mascarel I, van de Vijver MJ. Risk factors for recurrence and metastasis after breast-conserving therapy for ductal carcinoma-in-situ: analysis of European Organization for Research and Treatment of Cancer Trial 10853. J Clin Oncol. 2001 Apr 15;19(8):2263-71. doi: 10.1200/JCO.2001.19.8.2263.

  PMID: 11304780 BACKGROUND

• Cutuli B, Cohen-Solal-le Nir C, de Lafontan B, Mignotte H, Fichet V, Fay R, Servent V, Giard S, Charra-Brunaud C, Lemanski C, Auvray H, Jacquot S, Charpentier JC. Breast-conserving therapy for ductal carcinoma in situ of the breast: the French Cancer Centers' experience. Int J Radiat Oncol Biol Phys. 2002 Jul 15;53(4):868-79. doi: 10.1016/s0360-3016(02)02834-1.

  PMID: 12095552 BACKGROUND

• Cutuli B, Fourquet A, Luporsi E, Arnould L, Caron Y, Cremoux Pd, Dilhuydy JM, Fondrinier E, Fourme E, Giard-Lefevre S, Blanc-Onfroy ML, Lemanski C, Mauriac L, Sigal-Zafrani B, Tardivon A, This P, Tunon de Lara C, Kirova Y, Fabre N; Federation of French Cancer Centres (FNCLCC), et le groupe de travail SOR. [Standards, Options and Recommendations for the management of ductal carcinoma in situ of the breast (DCIS): update 2004]. Bull Cancer. 2005 Feb;92(2):155-68. French.

  PMID: 15749645 BACKGROUND

• Emdin SO, Granstrand B, Ringberg A, Sandelin K, Arnesson LG, Nordgren H, Anderson H, Garmo H, Holmberg L, Wallgren A; Swedish Breast Cancer Group. SweDCIS: Radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomised trial in a population offered mammography screening. Acta Oncol. 2006;45(5):536-43. doi: 10.1080/02841860600681569.

  PMID: 16864166 BACKGROUND

• Ernster VL, Barclay J, Kerlikowske K, Grady D, Henderson C. Incidence of and treatment for ductal carcinoma in situ of the breast. JAMA. 1996 Mar 27;275(12):913-8.

  PMID: 8598618 BACKGROUND

• Fine JP. Regression modeling of competing crude failure probabilities. Biostatistics. 2001 Mar;2(1):85-97. doi: 10.1093/biostatistics/2.1.85.

  PMID: 12933558 BACKGROUND

• Fisher B, Dignam J, Wolmark N, Wickerham DL, Fisher ER, Mamounas E, Smith R, Begovic M, Dimitrov NV, Margolese RG, Kardinal CG, Kavanah MT, Fehrenbacher L, Oishi RH. Tamoxifen in treatment of intraductal breast cancer: National Surgical Adjuvant Breast and Bowel Project B-24 randomised controlled trial. Lancet. 1999 Jun 12;353(9169):1993-2000. doi: 10.1016/S0140-6736(99)05036-9.

  PMID: 10376613 BACKGROUND

• Fisher B, Land S, Mamounas E, Dignam J, Fisher ER, Wolmark N. Prevention of invasive breast cancer in women with ductal carcinoma in situ: an update of the National Surgical Adjuvant Breast and Bowel Project experience. Semin Oncol. 2001 Aug;28(4):400-18. doi: 10.1016/s0093-7754(01)90133-2.

  PMID: 11498833 BACKGROUND

• Gagliardi G, Lax I, Soderstrom S, Gyenes G, Rutqvist LE. Prediction of excess risk of long-term cardiac mortality after radiotherapy of stage I breast cancer. Radiother Oncol. 1998 Jan;46(1):63-71. doi: 10.1016/s0167-8140(97)00167-9.

  PMID: 9488129 BACKGROUND

• Ho AY, Atencio DP, Peters S, Stock RG, Formenti SC, Cesaretti JA, Green S, Haffty B, Drumea K, Leitzin L, Kuten A, Azria D, Ozsahin M, Overgaard J, Andreassen CN, Trop CS, Park J, Rosenstein BS. Genetic predictors of adverse radiotherapy effects: the Gene-PARE project. Int J Radiat Oncol Biol Phys. 2006 Jul 1;65(3):646-55. doi: 10.1016/j.ijrobp.2006.03.006.

  PMID: 16751059 BACKGROUND

• Houghton J, George WD, Cuzick J, Duggan C, Fentiman IS, Spittle M; UK Coordinating Committee on Cancer Research; Ductal Carcinoma in situ Working Party; DCIS trialists in the UK, Australia, and New Zealand. Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK, Australia, and New Zealand: randomised controlled trial. Lancet. 2003 Jul 12;362(9378):95-102. doi: 10.1016/s0140-6736(03)13859-7.

  PMID: 12867108 BACKGROUND

• Omlin A, Amichetti M, Azria D, Cole BF, Fourneret P, Poortmans P, Naehrig D, Miller RC, Krengli M, Gutierrez Miguelez C, Morgan D, Goldberg H, Scandolaro L, Gastelblum P, Ozsahin M, Dohr D, Christie D, Oppitz U, Abacioglu U, Gruber G. Boost radiotherapy in young women with ductal carcinoma in situ: a multicentre, retrospective study of the Rare Cancer Network. Lancet Oncol. 2006 Aug;7(8):652-6. doi: 10.1016/S1470-2045(06)70765-3.

  PMID: 16887482 BACKGROUND

• Ozsahin M, Crompton NE, Gourgou S, Kramar A, Li L, Shi Y, Sozzi WJ, Zouhair A, Mirimanoff RO, Azria D. CD4 and CD8 T-lymphocyte apoptosis can predict radiation-induced late toxicity: a prospective study in 399 patients. Clin Cancer Res. 2005 Oct 15;11(20):7426-33. doi: 10.1158/1078-0432.CCR-04-2634.

  PMID: 16243816 BACKGROUND

• Solin LJ, Fourquet A, Vicini FA, Haffty B, Taylor M, McCormick B, McNeese M, Pierce LJ, Landmann C, Olivotto IA, Borger J, Kim J, de la Rochefordiere A, Schultz DJ. Mammographically detected ductal carcinoma in situ of the breast treated with breast-conserving surgery and definitive breast irradiation: long-term outcome and prognostic significance of patient age and margin status. Int J Radiat Oncol Biol Phys. 2001 Jul 15;50(4):991-1002. doi: 10.1016/s0360-3016(01)01517-6.

  PMID: 11429227 BACKGROUND

• Bourgier C, Cowen D, Castan F, Lemanski C, Gourgou S, Rivera S, Labib A, Peignaux K, Blanc-Onfroy ML, Benyoucef A, Mege A, Douadi-Gaci Z, Racadot S, Latorzeff I, Schick U, Jacquot S, Massabeau C, Guilbert P, Geffrelot J, Ellis S, Lecouillard I, Breton-Callu C, Richard-Tallet A, Boulbair F, Cretin J, Belkacemi Y, Bons F, Azria D, Fenoglietto P. Quality assurance program and early toxicities in the phase III BONBIS randomized trial evaluating the role of a localized radiation boost in ductal carcinoma in situ. Radiother Oncol. 2021 Nov;164:57-65. doi: 10.1016/j.radonc.2021.09.014. Epub 2021 Sep 24.

  PMID: 34571090 RESULT

• Bourgier C, Mollevi C, Cowen D, Castan F, Lemanski C, Gourgou S, Rivera S, Labib A, Peignaux K, Blanc-Onfroy ML, Benyoucef A, Mege A, Douadi-Gaci Z, Racadot S, Latorzeff I, Schick U, Jacquot S, Massabeau C, Guilbert P, Geffrelot J, Ellis S, Lecouillard I, Breton-Callu C, Richard-Tallet A, Boulbair F, Belliere A, Magne N, Belkacemi Y, Bons F, Fenoglietto P, Azria D. Late Toxicities and Quality of Life After a Radiation Boost for Breast Ductal Carcinoma In Situ: Boost or No Boost in DCIS Randomized Trial. Int J Radiat Oncol Biol Phys. 2026 Jan 1;124(1):109-121. doi: 10.1016/j.ijrobp.2025.07.1442. Epub 2025 Jul 31.

  PMID: 40752655 RESULT

Related Links

• Clinical trial summary from the National Cancer Institute's PDQ® database

MeSH Terms

Conditions

Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases; Adenocarcinoma; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Breast Carcinoma In Situ; Carcinoma in Situ; Neoplasms, Ductal, Lobular, and Medullary

Study Officials

• David Azria, MD, PhD

  Institut du Cancer de Montpellier - Val d'Aurelle

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 22, 2009
• First Posted: May 25, 2009
• Study Start: November 1, 2008
• Primary Completion: May 1, 2011
• Study Completion (Estimated): October 1, 2029
• Last Updated: February 5, 2026

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)