[Ductal in situ carcinoma: is it ethical to consider the breast conserving therapy as a standard?].
The increasing incidence of DCIS during the past 20 years needs a continuous evaluation of the treatment strategies and a multidisciplinary decision process. The management of the DCIS remains a challenging issue in 2003. Mastectomy should still be considered as the reference treatment which is able to guarantee cure in almost all cases, whereas breast conserving surgery followed by radiation therapy is associated with 7-10% of local recurrence. However, the increasing knowledge of the predictive factors of the local recurrence allows to propose a conservative treatment strategy to a large amount of patients, without negative impact on their prognosis. This review presents the arguments that permit to justify the reasoned choice of the different therapeutic options according to the clinico-pathological situations.
Barillot
I
I
Département de radiothérapie, centre de lutte contre le cancer Georges-François-Leclerc, 1, rue du Professeur-Marion, 21079 Dijon, France. ibarillot@dijon.fnclcc.fr
Cutuli
B
B
Arnould
L
L
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008327:Mammography; D008408:Mastectomy; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013629:Tamoxifen / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen