Published online Aug 10, 2014. doi: 10.5306/wjco.v5.i3.194
Revised: April 28, 2014
Accepted: May 29, 2014
Published online: August 10, 2014
Ductal carcinoma in situ (DCIS) is a non-obligate precursor of invasive breast cancer with a variable biological behavior which is difficult to accurately predict using the current clinico-pathological parameters. Randomized controlled trials have demonstrated that adjuvant radiotherapy (RT) reduces the risk of local recurrence after adequate local excision of DCIS. Tamoxifen may be considered as an adjuvant endocrine treatment in patients with high risk estrogen receptor positive disease. There is however a growing consensus that RT can be safely omitted in a subgroup of patients with favorable biological features in order to avoid overtreatment. The sentinel node biopsy is not routinely indicated but should be considered in women undergoing mastectomy for DCIS. The discovery of molecular signatures that accurately predict the biological behavior of this common malignancy will facilitate a personalized treatment approach in the future.
Core tip: Localized ductal carcinoma in situ (DCIS) is treated with adequate local excision followed by radiotherapy (RT) in most cases whereas extensive disease is treated with mastectomy (± immediate reconstruction). RT may be safely omitted in some patients with adequately excised low risk DCIS.