Up to Date Management of DCIS and Future Directions

• 作者: Manuel Muñoz
• 来源期刊: 乳腺癌(英文)
• 学科: 医学
• 关键词: Ductal Carcinoma in Situ DCIS Management of DCIS Treatment of DCIS Predictors of Recurrence of DCIS Risk Stratification Schemes for DCIS Active Surveillance for DCIS
• 年，卷（期）: 2020,（3）
• 页码范围: 78-100
• 页数: 23页
• 分类号: R73

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 schem