TITLE:
Up to Date Management of DCIS and Future Directions
AUTHORS:
Rodrigo Arrangoiz, Fernando Cordera, Eduardo Moreno, Enrique Luque-de-Leon, Manuel Muñoz
KEYWORDS:
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
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.9 No.3,
June
18,
2020
ABSTRACT: Ductal carcinoma in situ (DCIS)
is a non-invasive malignancy confined within 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 invasive ductal carcinoma
between 20% to 53% over ten or more years after initial diagnosis. The surgical and
adjuvant management of DCIS has advanced significantly in the last couple of
decades. Nonetheless, surgeons, medical oncologists, and radiation oncologists, along with their patients, still depend on
conventional clinical and pathologic risk
factors to make management decisions. Irrespective of the management strategy,
long-term survival is excellent. The debate around DCIS relates to
preventing either under-treatment or over-treatment. In this paper, we will
review the incidence and management options
of DCIS. Additionally, we will focus on several current disputes related 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.