title: ACR Appropriateness Criteria® Ductal Carcinoma in Situ.
abstract: Ductal carcinoma in situ (DCIS) is a breast neoplasm with potential for progression to invasive cancer. Management commonly involves excision, radiotherapy, and hormonal therapy. Surgical assessment of regional lymph nodes is rarely indicated except in cases of microinvasion or mastectomy. Radiotherapy is employed for local control in breast conservation, although it may be omitted for select low-risk situations. Several radiotherapy techniques exist beyond standard whole-breast irradiation (ie, partial-breast irradiation [PBI], hypofractionated whole-breast radiation); evidence for these is evolving. We present an update of the American College of Radiology (ACR) Appropriateness Criteria® for the management of DCIS. The ACR Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions, which are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review includes an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi technique) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Kaufman
authors.forename: Eleanor E R
authors.initials: EE
authors.lastname: Harris
authors.forename: Lisa
authors.initials: L
authors.lastname: Bailey
authors.forename: Manjeet
authors.initials: M
authors.lastname: Chadha
authors.forename: Sharon C
authors.initials: SC
authors.lastname: Dutton
authors.forename: Gary M
authors.initials: GM
authors.lastname: Freedman
authors.forename: Sharad
authors.initials: S
authors.lastname: Goyal
authors.forename: Michele Y
authors.initials: MY
authors.lastname: Halyard
authors.forename: Kathleen C
authors.initials: KC
authors.lastname: Horst
authors.forename: Kristina L M
authors.initials: KL
authors.lastname: Novick
authors.forename: Catherine C
authors.initials: CC
authors.lastname: Park
authors.forename: W Warren
authors.initials: WW
authors.lastname: Suh
authors.forename: Deborah
authors.initials: D
authors.lastname: Toppmeyer
authors.forename: Jennifer
authors.initials: J
authors.lastname: Zook
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Haffty
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000628:therapy*; D018275:Carcinoma, Lobular / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008408:Mastectomy; D015412:Mastectomy, Segmental; D009361:Neoplasm Invasiveness; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D021701:Sentinel Lymph Node Biopsy; D013629:Tamoxifen / Q000627:therapeutic use
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen