Ductal carcinoma in situ (DCIS) is a non-invasive malignancy confined within</span></span><span><span><span style="font-family:""><span style="font-family:Verdana;&...Ductal carcinoma in situ (DCIS) is a non-invasive malignancy confined within</span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> the basement membrane of the breast ductal system. There is a lot of disparity in the natural history of DCIS with an estimated incidence of progression to </span><span style="font-family:Verdana;">invasive ductal carcinoma between 20%</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 53% over ten or more years afte</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">r </span><span style="font-family:Verdana;">initial diagnosis. The surgical and adjuvant management of DCIS has advanced significantly in the last couple of decades. Nonetheless, surgeons, medical oncologist</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">, and radiation oncologists, along with their patients, still depend on conve</span><span style="font-family:Verdana;">ntional clinical and pathologic risk factors to make management decisions. Irrespective of the management strategy, long-term survival is excel</span><span style="font-family:Verdana;">lent. The debate around DCIS relates to preventing either under-treatment or over-treatment. In this paper, we will review the incidence and management </span><span style="font-family:Verdana;">options of DCIS. Additionally, we will focus on several current disputes related</span><span style="font-family:Verdana;"> to the management of DCIS, including breast conserving surgery, the role of radiation in breast conservation surgery, sentinel node biopsy in DCIS, hormonal therapy, various risk stratification schemes, and the option of active surveillance for low-risk DCIS.展开更多
More than 90% of breast cancer-related deaths are caused by metastasis not primary tumor. To effectively reduce cancer mortality, it is extremely important to predict the risk of, and to intervene in, the critical tra...More than 90% of breast cancer-related deaths are caused by metastasis not primary tumor. To effectively reduce cancer mortality, it is extremely important to predict the risk of, and to intervene in, the critical transition from展开更多
Abstract: Ductal carcinoma in-situ DCIS is a heterogeneous entity in breast neoplasm with unpredictable biological behavior. This poses challenge in the management of DCIS. Various trials on DCIS have shown good outco...Abstract: Ductal carcinoma in-situ DCIS is a heterogeneous entity in breast neoplasm with unpredictable biological behavior. This poses challenge in the management of DCIS. Various trials on DCIS have shown good outcome with integral treatment of adequate surgery, radiotherapy and hormonal therapy. Identification of subgroup of DCIS for radiotherapy and hormonal therapy could improve recurrence rate, contralateral tumours incidence and perhaps overall survival. Various risk score calculations could help to direct radiotherapy and hormonal treatment verses surgery alone and to avoid over treatment. Oncotype DX assay could be a new way of risk calculation to direct types of DCIS treatment. The recent increased use of MRI could increase the detection of DCIS and a more accurate extent of disease estimation. This article is a summary of major literatures and major trials result for DCIS.展开更多
文摘Ductal carcinoma in situ (DCIS) is a non-invasive malignancy confined within</span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> the basement membrane of the breast ductal system. There is a lot of disparity in the natural history of DCIS with an estimated incidence of progression to </span><span style="font-family:Verdana;">invasive ductal carcinoma between 20%</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 53% over ten or more years afte</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">r </span><span style="font-family:Verdana;">initial diagnosis. The surgical and adjuvant management of DCIS has advanced significantly in the last couple of decades. Nonetheless, surgeons, medical oncologist</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">, and radiation oncologists, along with their patients, still depend on conve</span><span style="font-family:Verdana;">ntional clinical and pathologic risk factors to make management decisions. Irrespective of the management strategy, long-term survival is excel</span><span style="font-family:Verdana;">lent. The debate around DCIS relates to preventing either under-treatment or over-treatment. In this paper, we will review the incidence and management </span><span style="font-family:Verdana;">options of DCIS. Additionally, we will focus on several current disputes related</span><span style="font-family:Verdana;"> to the management of DCIS, including breast conserving surgery, the role of radiation in breast conservation surgery, sentinel node biopsy in DCIS, hormonal therapy, various risk stratification schemes, and the option of active surveillance for low-risk DCIS.
文摘More than 90% of breast cancer-related deaths are caused by metastasis not primary tumor. To effectively reduce cancer mortality, it is extremely important to predict the risk of, and to intervene in, the critical transition from
文摘Abstract: Ductal carcinoma in-situ DCIS is a heterogeneous entity in breast neoplasm with unpredictable biological behavior. This poses challenge in the management of DCIS. Various trials on DCIS have shown good outcome with integral treatment of adequate surgery, radiotherapy and hormonal therapy. Identification of subgroup of DCIS for radiotherapy and hormonal therapy could improve recurrence rate, contralateral tumours incidence and perhaps overall survival. Various risk score calculations could help to direct radiotherapy and hormonal treatment verses surgery alone and to avoid over treatment. Oncotype DX assay could be a new way of risk calculation to direct types of DCIS treatment. The recent increased use of MRI could increase the detection of DCIS and a more accurate extent of disease estimation. This article is a summary of major literatures and major trials result for DCIS.
