Treatment of ductal carcinoma in situ: Considerations for tailoring therapy in the contemporary era Review
| Authors: | Mamtani, A.; Van Zee, K. J. |
| Review Title: | Treatment of ductal carcinoma in situ: Considerations for tailoring therapy in the contemporary era |
| Abstract: | Purpose of Review: Standard options for the treatment of ductal carcinoma in situ (DCIS) include breast-conserving surgery (BCS) alone; BCS with radiotherapy or endocrine therapy, or both; and mastectomy. Survival is excellent with all options, but rates of local recurrence (LR) vary, as do quality-of-life measures. Here, we discuss treatment outcomes, risk factors for LR, and tools for risk estimation. Recent Findings: After BCS, radiotherapy reduces the risk of LR by half, and endocrine therapy reduces the risk by a third. Young age, inadequate margins, and greater volume of disease are associated with higher risk of LR after BCS, while young age, high grade, and microinvasion are associated with higher risk of locoregional recurrence after mastectomy. Clinical tools, including the Memorial Sloan Kettering Cancer Center (MSKCC) DCIS nomogram, provide LR risk estimates after BCS that appear more accurate than current genomic assays. The safety of active surveillance for seemingly low-risk patients remains uncertain. Summary: Estimation of LR risk, utilizing a multitude of clinicopathologic and treatment factors, can help a woman balance that risk with her values and priorities, and allow her to choose the optimal treatment option for her. © 2020, Springer Science+Business Media, LLC, part of Springer Nature. |
| Keywords: | clinical feature; review; cancer recurrence; cancer adjuvant therapy; cancer radiotherapy; recurrence risk; cancer grading; mastectomy; cancer therapy; risk factor; age; risk assessment; cancer hormone therapy; nomograms; partial mastectomy; genomics; cancer epidemiology; intraductal carcinoma; ductal carcinoma in situ; personalized medicine; local recurrence; breast-conserving surgery; tumor invasion; low risk patient; human; risk estimation |
| Journal Title: | Current Breast Cancer Reports |
| Volume: | 12 |
| Issue: | 2 |
| ISSN: | 1943-4588 |
| Publisher: | Springer |
| Date Published: | 2020-06-01 |
| Start Page: | 98 |
| End Page: | 106 |
| Language: | English |
| DOI: | 10.1007/s12609-020-00360-5 |
| PROVIDER: | scopus |
| PUBMED: | 33552389 |
| PMCID: | PMC7863731 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 1 July 2020 -- Source: Scopus |
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