Ductal carcinoma in situ: an overview

Abstract

Advances in methods used to diagnose breast cancer have resulted in the increased detection of ductal carcinoma in situ; most of these are detected by screening mammograms and are confirmed by core needle biopsy. Currently, classification schemas are moving toward a molecular approach. Treatment options for patients with ductal carcinoma in situ are multiple and take into consideration end points such as local, regional or distant recurrence, overall survival and quality of life. Treatment methods continue to be controversial and debated in the oncology community. The quality of local control is multifactorial and depends on adequate surgical clearance, biological characteristics of the tumor, clinical presentation and the possibility of radiation therapies.

Keywords::

• adjuvant therapy
• breast cancer
• DCIS
• intraductal
• lumpectomy
• mammography
• mastectomy
• radiotherapy
• tamoxifen
• whole breast irradiation

Financial & competing interests disclosure

This work was supported by NCI-U10-CA-12027, U10-CA-37377, U10-CA-69974, U10-CA-69651 and U10-CA-21661. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Trial registration

NSABP B-24: PDQ NSABP-B-24

NSABP B-35: NCT00053898

NSABP B-43: NCT00769379

Related work

This work is an original review that has not been published elsewhere. Previous, related works are as follows:

Fisher B, Land S, Mamounas E et al. Prevention of invasive breast cancer in women with ductal carcinoma in situ: an update of the National Surgical Adjuvant Breast and Bowel Project experience. Semin. Oncol. 28, 400–418 (2001).

Wapnir IL, Dignam JJ, Fisher B et al. Long-term outcomes of invasive ipsilateral breast tumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS. J. Natl Cancer Inst. 103(6), 478–488 (2011).

Fisher B, Costantino J, Redmond C et al. Lumpectomy compared with lumpectomy and radiation therapy for the treatment of intraductal breast cancer. N. Engl. J. Med. 328(22), 1581–1586 (1993).

Fisher B, Dignam J, Wolmark N et al. Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17. J. Clin. Oncol. 16(2), 441–452 (1998).

Julian TB, Land SR, Wang Y et al. Is boost therapy necessary in the treatment of DCIS? J. Clin. Oncol. (Meeting Abstracts) Vol. 26 No. 15 (Suppl. 537) 2008.

Allred DC, Anderson SJ, Paik S et al. Adjuvant tamoxifen reduces subsequent breast cancer in women with estrogen receptor-positive ductal carcinoma in situ: a study based on NSABP protocol B-24. J. Clin. Oncol. 30(12), 1268–1273 (2012).