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Current Treatment Options in Oncology

, Volume 14, Issue 1, pp 75–87 | Cite as

Is DCIS Breast Cancer, and How Do I Treat it?

  • N. BijkerEmail author
  • M. Donker
  • J. Wesseling
  • G. J. den Heeten
  • E. J. Th. Rutgers
Breast Cancer (CI Falkson, Section Editor)
First Online:

Opinion statement

Ductal carcinoma in situ (DCIS) is a pre-invasive stage of breast cancer with a heterogeneous clinical behaviour. Since the introduction of mammographic screening programmes, the incidence of DCIS has shown a dramatic increase. Treatment should focus on the prevention of progression to invasive disease. If progression occurs, poorly differentiated DCIS frequently gives rise to grade III invasive breast cancer, whereas well differentiated DCIS more often recurs as grade I invasive disease. However, at present, validated diagnostic test are lacking to predict progression accurately. The majority of women with DCIS are suitable for breast conserving therapy. Obtaining clear surgical margins is the most important goal of a local excision. Radiotherapy is effective in reducing the risk of local recurrence with about 50 % in all subgroups of patients with DCIS. (Breast cancer specific) survival of women with DCIS is excellent, and radiotherapy does not further improve this. Future research should be directed in enabling to select women who have a high risk of—invasive—recurrence, so in which radiotherapy should be standard part of the breast conserving approach, and those women with a more indolent lesion, in which after surgery a watchful waiting approach can be followed.

Keywords

Ductal carcinoma in situ DCIS Breast cancer Breast conserving therapy Surgery radiotherapy Mammogram MRI 
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Notes

Disclosure

No potential conflicts of interest relevant to this article were reported.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media New York 2012

Authors and Affiliations

  • N. Bijker
    • 1
    Email author
  • M. Donker
    • 2
  • J. Wesseling
    • 3
  • G. J. den Heeten
    • 4
  • E. J. Th. Rutgers
    • 2
  1. 1.Department of Radiation Oncology, Academic Medical CenterAmsterdamThe Netherlands
  2. 2.Department of Surgical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
  3. 3.Department of Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
  4. 4.Department of Radiology/Biomedical Engineering and Physics, Academic Medical CenterAmsterdamThe Netherlands

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