Management of ductal carcinoma in situ of the breast.
The advent of mammographic breast screening has increased the detection of ductal carcinoma in situ (DCIS), which now accounts for 15-20% of all breast cancer. While symptomatic DCIS has been treated satisfactorily by mastectomy, this may be an overtreatment of smaller screen-detected lesions. Although local excision, with or without radiotherapy, is associated with a significant risk of local recurrence of DCIS or invasive cancer, salvage surgery is usually successful. The long-term breast-specific mortality rate of treatment by mastectomy and local excision are similar. Whereas mastectomy is still appropriate for women with lesions > 30 mm in diameter or centrally placed and for those women who demand the best possible disease-free survival, local surgery should otherwise be considered.
Carty
N J
NJ
University Surgical Unit, Royal South Hants Hospital, Southampton.
Carter
C
C
Royle
G T
GT
Johnson
C D
CD
D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D002278:Carcinoma in Situ / Q000532:radiotherapy / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008403:Mass Screening; D008408:Mastectomy / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant