| Abstract: |
Noninvasive breast cancer is labeled as a cancer, or sometimes a precancer, found in the breast but lacking the ability to invade beyond its origin or to spread beyond the breast. The cancers that originate in the lobules are called lobular carcinomas in situ, and those that originate in the duct structures are called ductal carcinomas in situ. Lobular carcinoma in situ is discussed elsewhere in this textbook; its diagnosis indicates an increased risk for developing a future breast cancer, but these lesions are not treated with radiation once the diagnosis has been established. Women with ductal carcinoma in situ frequently choose breast-conservation surgery, and several large clinical trials comparing whole-breast radiation to none have concluded that the addition of radiation decreases the risk of a local recurrence in the breast by at least 50%, although no impact on patient survival is observed. More recently, trials have focused on selected “good-risk” subtypes of duct carcinoma in situ, which appear to have a lower risk of local recurrence. A prospective “observation after surgery” trial and a prospective randomized trial comparing radiation to none following breast-conservation surgery have both identified the risk of recurrence both with and without radiation as lower than predicted. For patients with this good-risk duct carcinoma in situ, the omission of whole-breast radiation may be considered as a treatment option following breast-conservation surgery. © Springer International Publishing AG 2017. |
