摘要
Ductal carcinoma in situ (DCIS) is a non-invasive malignancy confined within</span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> the basement membrane of the breast ductal system. There is a lot of disparity in the natural history of DCIS with an estimated incidence of progression to </span><span style="font-family:Verdana;">invasive ductal carcinoma between 20%</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 53% over ten or more years afte</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">r </span><span style="font-family:Verdana;">initial diagnosis. The surgical and adjuvant management of DCIS has advanced significantly in the last couple of decades. Nonetheless, surgeons, medical oncologist</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">, and radiation oncologists, along with their patients, still depend on conve</span><span style="font-family:Verdana;">ntional clinical and pathologic risk factors to make management decisions. Irrespective of the management strategy, long-term survival is excel</span><span style="font-family:Verdana;">lent. The debate around DCIS relates to preventing either under-treatment or over-treatment. In this paper, we will review the incidence and management </span><span style="font-family:Verdana;">options of DCIS. Additionally, we will focus on several current disputes related</span><span style="font-family:Verdana;"> to the management of DCIS, including breast conserving surgery, the role of radiation in breast conservation surgery, sentinel node biopsy in DCIS, hormonal therapy, various risk stratification schemes, and the option of active surveillance for low-risk DCIS.
Ductal carcinoma in situ (DCIS) is a non-invasive malignancy confined within</span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> the basement membrane of the breast ductal system. There is a lot of disparity in the natural history of DCIS with an estimated incidence of progression to </span><span style="font-family:Verdana;">invasive ductal carcinoma between 20%</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> to</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> 53% over ten or more years afte</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">r </span><span style="font-family:Verdana;">initial diagnosis. The surgical and adjuvant management of DCIS has advanced significantly in the last couple of decades. Nonetheless, surgeons, medical oncologist</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">, and radiation oncologists, along with their patients, still depend on conve</span><span style="font-family:Verdana;">ntional clinical and pathologic risk factors to make management decisions. Irrespective of the management strategy, long-term survival is excel</span><span style="font-family:Verdana;">lent. The debate around DCIS relates to preventing either under-treatment or over-treatment. In this paper, we will review the incidence and management </span><span style="font-family:Verdana;">options of DCIS. Additionally, we will focus on several current disputes related</span><span style="font-family:Verdana;"> to the management of DCIS, including breast conserving surgery, the role of radiation in breast conservation surgery, sentinel node biopsy in DCIS, hormonal therapy, various risk stratification schemes, and the option of active surveillance for low-risk DCIS.