Leveraging the variable natural history of ductal carcinoma in situ (DCIS) to select optimal therapy
Ductal carcinoma in situ (DCIS) is a non-obligate precursor to invasive ductal carcinoma. The authors sought to discuss the evidence suggesting that not all DCIS will progress to invasive disease if left untreated.
Four lines of evidence align to suggest that not all of this in-situ disease progresses to invasive cancer: its prevalence on screening mammography, studies of missed diagnoses, incidental findings in autopsy specimens, and large retrospective reviews of those treated with excision alone.
A clearer understanding of the variable history of DCIS coupled with advances in genomic profiling of the disease holds the promise of reducing widespread over-treatment of this non-invasive cancer. Additionally, identification of higher risk of recurrence subsets may select patients for whom more aggressive treatment may be appropriate.
KeywordsDuctal carcinoma in situ DCIS Breast cancer Breast cancer screening Breast cancer genomic profiling Oncotype DCIS Oncotype Dx
Compliance with ethical standards
Conflict of interest
Dr. Rojas and Dr. Fortes declare that they have no conflicts of interest. Dr. Borgen has received a speaker honorarium from Company Genomic Health, Inc.
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