Local control of ductal carcinoma in situ based on tumor and patient characteristics: the surgeon's perspective.
Ductal carcinoma in situ (DCIS) is a disease whose manifestations are largely confined to in-breast pathology. Management strategies therefore focus on various combinations of local therapy: mastectomy, lumpectomy alone, and lumpectomy followed by breast irradiation. Although DCIS does not carry an inherent risk of distant organ metastasis, optimal local control is essential because any in-breast or chest wall recurrence may occur as an invasive lesion. Local recurrence has been reported following breast-conserving surgery as well as mastectomy. Breast radiation is therefore generally recommended following breast-conserving surgery, and in selected circumstances, mastectomy may be the preferred treatment strategy. This article reviews the surgical and associated clinicopathologic issues related to initial biopsy and perioperative planning that should be considered for all DCIS cases to optimize local control.
Newman
Lisa A
LA
Department of Surgery, Breast Care Center, University of Michigan Comprehensive Cancer Center, 1500 East Medical Center Dr, 3308 Cancer Center, Ann Arbor, MI 48109-0932, USA. lanewman@umich.edu
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008327:Mammography; D008408:Mastectomy; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D009366:Neoplasm Seeding; D018714:Radiotherapy, Adjuvant; D013048:Specimen Handling; D013629:Tamoxifen / Q000627:therapeutic use; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen