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Ductal Carcinoma in Situ

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Breast Cancer Management for Surgeons

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Abstract

Ductal carcinoma in situ (DCIS) represents some 25% of screen-detected breast neoplasia. Established clinical practice includes surgery, radiotherapy and endocrine therapy, to reduce the likelihood of DCIS recurrence or progression to invasive breast cancer. There is a 2–3% mortality from breast cancer at 10–20 years in those originally diagnosed with DCIS. Radiotherapy significantly reduces the likelihood of local recurrence, while endocrine therapy principally reduces the incidence of local recurrence and contralateral breast neoplasia. However, neither radiotherapy nor endocrine therapy significantly alters long-term breast cancer-specific survival. The range of biological behaviour compared with the impact of treatment has emphasised concerns about overdiagnosis and overtreatment. Current studies seek to determine the value of biomarkers in DCIS, while others question the need for surgical excision and radiotherapy compared with active surveillance for low-risk DCIS.

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Authors and Affiliations

  1. Baylor College of Medicine, Department of Surgery, One Baylor College, BCM 390, Houston, TX, 77030, USA

    Stacey A. Carter MD

  2. King’s College London, Guy’s and St Thomas’ Hospitals, 3rd Floor, Bermondsey Wing, Great Maze Pond, London, SE1 9RT, UK

    Sarah E. Pinder MBChB, FRCPath

  3. University of Texas M.D. Anderson Cancer Center, 1400 Pressler Drive, FCT.6092, Unit 1434, Houston, TX, 77030-4008, USA

    Alastair M. Thompson ALCM, BSc, MB ChB, MD, FRCSEd

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  1. Stacey A. Carter MD
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  3. Alastair M. Thompson ALCM, BSc, MB ChB, MD, FRCSEd
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Correspondence to Alastair M. Thompson ALCM, BSc, MB ChB, MD, FRCSEd .

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  1. The Medical School Department of Oncology, University of Sheffield, Sheffield, United Kingdom

    Lynda Wyld

  2. Athens University Medical School, Athens, Greece

    Christos Markopoulos

  3. Helsinki University Hospital, Helsinki, Finland

    Marjut Leidenius

  4. Department of Oncology & Radiotherapy, Gdańsk Medical University Department of Oncology & Radiotherapy, Gdańsk, Poland

    Elżbieta Senkus-Konefka

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Carter, S.A., Pinder, S.E., Thompson, A.M. (2018). Ductal Carcinoma in Situ. In: Wyld, L., Markopoulos, C., Leidenius, M., Senkus-Konefka, E. (eds) Breast Cancer Management for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-319-56673-3_11

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