title: Evolving paradigm for imaging, diagnosis, and management of DCIS.
abstract: Our understanding of the biology of breast cancer has dramatically expanded over the past decade, revealing that breast cancer is a heterogeneous group of diseases. This new knowledge can generate insights to improve screening performance and the management of ductal carcinoma in situ. In this article, the authors review the current state of the science of breast cancer and tools that can be used to improve screening and risk assessment. They describe several opportunities to improve clinical screening: (1) radiologists interpreting mammograms should aim to differentiate between the risk for invasive cancer and ductal carcinoma in situ to better assess the time frame for disease progression and the need for and optimal timing of biopsy; (2) imaging features associated with low risk, slow-growing cancer versus high risk, fast-growing cancer should be better defined and taught; and (3) as we learn more about assessing an individual's risk for developing breast cancer, we should incorporate these factors into a strategy for personalized screening to maximize benefit and minimize harm.
authors.affiliation: Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, California.
authors.forename: Colin J
authors.initials: CJ
authors.lastname: Wells
authors.forename: Cristina
authors.initials: C
authors.lastname: O'Donoghue
authors.forename: Haydee
authors.initials: H
authors.lastname: Ojeda-Fournier
authors.forename: Hanna E G
authors.initials: HE
authors.lastname: Retallack
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Esserman
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D011856:Radiographic Image Enhancement / Q000379:methods*; D018570:Risk Assessment / Q000379:methods
keywords: Ductal carcinoma in situ; breast cancer; overtreatment; risk assessment; screening