A review of the management of ductal carcinoma in situ following breast conserving surgery.
Ductal carcinoma in situ (DCIS) is a heterogeneous, pre-malignant disease accounting for 10-20% of all new breast tumours. Evidence shows a statistically significant local control benefit for adjuvant radiotherapy (RT) following breast conserving surgery (BCS) for all patients. The baseline recurrence risk of individual patients varies according to clinical-pathological criteria and in selected patients, omission of RT may be considered, following a discussion with the patient. The role of adjuvant endocrine therapy remains uncertain. Ongoing studies are attempting to define subgroups of patients who are at sufficiently low risk of recurrence that RT may be safely omitted; investigating RT techniques and dose fractionation schedules; and defining the role of endocrine therapy. Future directions in the management of patients with DCIS will include investigation of prognostic and predictive biomarkers to inform individualised therapy tailored to the risk of recurrence.
Liverpool Cancer Therapy Centre, Sydney, Australia. Electronic address: miriam.boxer@sswahs.nsw.gov.au.
M M
MM
Boxer
G P
GP
Delaney
B H
BH
Chua
D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D013629:Tamoxifen / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen
Breast conservation; Ductal carcinoma in situ; Endocrine treatment; Radiotherapy