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Ductal Carcinoma in Situ

  • BBSG – Brazilian Breast Study Group
Chapter

Abstract

Ductal carcinoma in situ (DCIS) is part of the group of precursor lesions of breast cancer. It is characterized by proliferation of neoplastic cells within the mammary ducts, without rupture of the basal membrane.

Recommended Reading

  1. 1.
    Davis KL, Barth RJ, Gui J, et al. Use of MRI in preoperative planning for women with newly diagnosed DCIS: risk or benefit? Ann Surg Oncol. 2012;19:3270–4. Retrospective assessment of 218 patients who underwent surgical treatment for DCIS, in which 154 patients underwent preoperative magnetic resonance imaging and 64 did not. There were no differences between the size of the resected area, neither a decrease in the rates of re-excision and conversion to mastectomy in patients who underwent preoperative MRI. It is also important to point out that there was a significant increase in costs and a delay in starting treatment in the MRI group.CrossRefGoogle Scholar
  2. 2.
    Goodwin A, Parker S, Ghersi D, Wilcken N. Post-operative radiotherapy for ductal carcinoma in situ of the breast. Cochrane Database Syst Rev. 2009; 1:Art.No.:CD000563. Systematic review of the four randomized studies on RT in DCIS: NSABP B17, EORTC 10353, UKCCCR and SweDCIS. Reduction in total relapses: 51% (95% IC, 0.41-0.59), benefit in all subgroups of patients and negligible side effects. Interpretation: RT should always be used after BCS.Google Scholar
  3. 3.
    Morrow M, Van Zee K, Solin L, et al. Society of Surgical Oncology – American Society of Radiation Oncology – American Society of Clinical Oncology guideline on margins for breast-conserving surgery with whole-breast irradiation in ductal carcinoma in situ. J Clin Oncol. 2016;34:4040–6. Consensus of the American Societies (ASCO, ASTRO, SSO) evidencing the minimum necessary margin in patients submitted to conservative surgery and radiotherapy. The use of margins greater than 2 mm did not bring benefit in relation to the decrease of local recurrenceCrossRefGoogle Scholar
  4. 4.
    Staley H, McCallum I, Bruce J. Postoperative tamoxifen for ductal carcinoma in situ. Cochrane Database Syst Rev. 2012;10:CD007847. A retrospective study of 174 patients with DCIS who underwent magnetic resonance imaging before surgery. There was an increase in costs and a delay in starting treatment. On the other hand, there was no reduction in the number of re-interventions and did not reduce the risk of conversion from conservative surgery to radical surgery.PubMedGoogle Scholar
  5. 5.
    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. 2011;103:478–88. The NSABP B-17 and B24 trials are the most important prospective studies related to conservative surgery in the treatment of DCIS. At 15 years of follow-up, the local recurrence rate was 19.4% in patients who underwent conservative surgery alone, compared to 8.5% in patients receiving Tamoxifen and Radiotherapy.CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • BBSG – Brazilian Breast Study Group
    • 1
  1. 1.BBSGSao PauloBrazil

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