title: Current view on ductal carcinoma in situ and importance of the margin thresholds: A review.
abstract: Ductal carcinoma in situ (DCIS) is a heterogeneous group of diseases that differ in biology and clinical behaviour. Until 1980, DCIS represented less than 1% of all breast cancer cases. With the increased utilization of mammography, DCIS now accounts for 15% to 25% of newly diagnosed breast cancer cases. The Van Nuys Prognostic Index (VPNI) is a commonly used tool for ductal carcinoma in situ (DCIS) treatment approach. Patient age, tumour size, tumour margins and pathological grade are used in order to stratify patients into three groups pertaining to risk of local recurrence: low-, intermediate- and high risk. Patients in the low-risk subgroup will always be treated with excision alone, while in the highest subgroup mastectomy is the safest option. Just like invasive breast cancer (IBC) there might be a curative dilemma in the intermediate-risk group. Many trials confirm that tumour margins are the most important prognostic factor of local recurrence for DCIS patients treated with breast conserving surgery alone or with breast conserving surgery plus radiotherapy. In this article we focused specifically on the literature concerning margin thresholds.
authors.affiliation: Antwerp University, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Wilrijk, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Van Cleef
authors.affiliation: Department of Medical Oncology, Breast Cancer and Gynecological Oncology Unit, Antwerp University Hospital, Edegem, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Altintas
authors.affiliation: Department of Medical Oncology, Breast Cancer and Gynecological Oncology Unit, Antwerp University Hospital, Edegem, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Huizing
authors.affiliation: Department of Medical Oncology, Breast Cancer and Gynecological Oncology Unit, Antwerp University Hospital, Edegem, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Papadimitriou
authors.affiliation: Department of Medical Oncology, Breast Cancer and Gynecological Oncology Unit, Antwerp University Hospital, Edegem, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Van Dam
authors.affiliation: Department of Medical Oncology, Breast Cancer and Gynecological Oncology Unit, Antwerp University Hospital, Edegem, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: Tjalma
keywords: Breast cancer; DCIS; DCIS outcome; DCIS treatment; VNPI; Van Nuys Prognostic Index; carcinoma in situ