Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Ductal Carcinoma in Situ

  • Chapter
Management of Breast Diseases

Abstract

Ductal carcinoma in situ (DCIS), also known as intraductal cancer, is characterized by the proliferation of malignant mammary ductal epithelial cells without evidence of invasion beyond the basement membrane. In the past, DCIS was an uncommon lesion, and was considered a favorable type of carcinoma, which was readily cured by mastectomy. The use of screening mammography has resulted in a remarkable increase in the incidence (or detection rate) of DCIS. Between 1973 and 1992, age adjusted incidence rates of DCIS rose from 2.3 to 15.8 per 100,000 women, a 58% increase. In comparison, the incidence of invasive breast cancer increased by 34.3% in the same period [1]. This increase was observed for both White and African-American women and in those over and under 50 years of age. However, it appears that DCIS accounts for a higher proportion of screen-detected cancers in women aged 40–49 years than in their older counterparts.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ernster VL, Barclay J, Kerlikowske K et al (1996) Incidence of and treatment for ductal carcinoma in situ of the breast. JAMA. 275:913–8

    CAS  PubMed  Google Scholar 

  2. Ernster VL, Ballard-Barbash R, Barlow WE et al (2002) Detection of ductal carcinoma in situ in women undergoing screening mammography. J Natl Cancer Inst. 94:1546–54

    PubMed  Google Scholar 

  3. Li CI, Daling JR, Malone KE (2005) Age-specific incidence rates of in situ breast carcinomas by histologic type, 1980 to 2001. Cancer Epidemiol Biomark Prev. 14:1008–11

    Google Scholar 

  4. Li CI, Malone KE, Saltzman BS et al (2006) Risk of invasive breast carcinoma among women diagnosed with ductal carcinoma in situ and lobular carcinoma in situ, 1988–2001. Cancer. 106:2104–12

    PubMed  Google Scholar 

  5. Rosner D, Bedwani RN, Vana J et al (1980) Noninvasive breast carcinoma: results of a National Survey by the American College of Surgeons. Ann Surg. 192:139–47

    CAS  PubMed  Google Scholar 

  6. Goedde TA, Frykberg ER, Crump JM et al (1992) The impact of mammography on breast biopsy. Am Surg. 58: 661–6

    CAS  PubMed  Google Scholar 

  7. Ikeda DM, Andersson I (1989) Ductal carcinoma in situ: atypical mammographic appearances. Radiology. 172:661–6

    CAS  PubMed  Google Scholar 

  8. Holland R, Hendriks JH (1994) Microcalcifications associated with ductal carcinoma in situ: mammographic-pathologic correlation. Semin Diagn Pathol. 11:181–92

    CAS  PubMed  Google Scholar 

  9. Stomper PC, Connolly JL (1992) Ductal carcinoma in situ of the breast: correlation between mammographic calcification and tumor subtype. AJR Am J Roentgenol. 159:483–5

    CAS  PubMed  Google Scholar 

  10. Holland R, Hendriks JH, Vebeek AL et al (1990) Extent, distribution and mammographic/histological correlations of breast ductal carcinoma in situ. Lancet. 335:519–22

    CAS  PubMed  Google Scholar 

  11. Evans A (2003) The diagnosis and management of pre-invasive breast disease: radiological diagnosis. Breast Cancer Res. 5:250–3

    PubMed  Google Scholar 

  12. Gilles R, Guinebretiere JM, Lucidarme O et al (1994) Nonpalpable breast tumors: diagnosis with contrast-enhanced subtraction dynamic MR imaging. Radiology. 191:625–31

    CAS  PubMed  Google Scholar 

  13. Orel SG, Schnall MD, Powell CM et al (1995) Staging of suspected breast cancer: effect of mrimaging and MR-guided biopsy. Radiology. 196:115–22

    CAS  PubMed  Google Scholar 

  14. Boetes C, Mus RD, Holland R et al (1995) Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent. Radiology. 197:743–7

    CAS  PubMed  Google Scholar 

  15. Fobben ES, Rubin CZ, Kalisher L et al (1995) Breast MR imaging with commercially available techniques: radiologicpathologic correlation. Radiology. 196:143–52

    CAS  PubMed  Google Scholar 

  16. Bluemke DA, Gatsonis CA, Chen MH et al (2004) Magnetic resonance imaging of the breast prior to biopsy. JAMA. 292:2735–42

    CAS  PubMed  Google Scholar 

  17. Kriege M, Brekelmans CT, Boetes C et al (2004) Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med. 351:427–37

    CAS  PubMed  Google Scholar 

  18. Kuhl CK, Schrading S, Bieling HB et al (2007) MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet. 370:485–92

    PubMed  Google Scholar 

  19. Menell JH, Morris EA, Dershaw DD et al (2005) Determination of the presence and extent of pure ductal carcinoma in situ by mammography and magnetic resonance imaging. Breast J. 11:382–90

    PubMed  Google Scholar 

  20. Gilles R, Zafrani B, Guinebretiere JM et al (1995) Ductal carcinoma in situ: MR imaging-histopathologic correlation. Radiology. 196:415–9

    CAS  PubMed  Google Scholar 

  21. Schouten van der Velden AP, Boetes C, Bult P et al (2006) The value of magnetic resonance imaging in diagnosis and size assessment of in situ and small invasive breast carcinoma. Am J Surg. 192:172–8

    PubMed  Google Scholar 

  22. Esserman LJ, Kumar AS, Herrera AF et al (2006) Magnetic resonance imaging captures the biology of ductal carcinoma in situ. J Clin Oncol. 24:4603–10

    PubMed  Google Scholar 

  23. Solin LJ, Orel SG, Hwang WT et al (2008) Relationship of breast magnetic resonance imaging to outcome after breast-conservation treatment with radiation for women with early-stage invasive breast carcinoma or ductal carcinoma in situ. J Clin Oncol. 26:386–91

    PubMed  Google Scholar 

  24. Jackman RJ, Nowels KW, Rodriguez-Soto J et al (1999) Stereotactic, automated, large-core needle biopsy of nonpalpable breast lesions: false-negative and histologic underestimation rates after long-term follow-up. Radiology. 210: 799–805

    CAS  PubMed  Google Scholar 

  25. Groenewoud JH, Pijnappel RM, van den Akker-Van Marle ME et al (2004) Cost-effectiveness of stereotactic large-core needle biopsy for nonpalpable breast lesions compared to open-breast biopsy. Br J Cancer. 90:383–92

    CAS  PubMed  Google Scholar 

  26. Gundry KR, Berg WA (1998) Treatment issues and core needle breast biopsy: clinical context. AJR Am J Roentgenol. 171:41–9

    CAS  PubMed  Google Scholar 

  27. Pfarl G, Helbich TH, Riedl CC et al (2002) Stereotactic 11-gauge vacuum-assisted breast biopsy: a validation study. AJR Am J Roentgenol. 179:1503–7

    PubMed  Google Scholar 

  28. Golub RM, Bennett CL, Stinson T et al (2004) Cost minimization study of image-guided core biopsy versus surgical excisional biopsy for women with abnormal mammograms. J Clin Oncol. 22:2430–7

    PubMed  Google Scholar 

  29. Morrow M, Harris JR (2007) Practice guideline for the management of ductal carcinoma in-situ of the breast (dcis). J Am Coll Surg. 205:145–61

    Google Scholar 

  30. Bassett L, Winchester DP, Caplan RB et al (1997) Stereotactic core-needle biopsy of the breast: a report of the joint task force of the American college of radiology, American college of surgeons and college of American pathologists. CA Cancer J Clin. 47:171–90

    CAS  PubMed  Google Scholar 

  31. Melotti MK, Berg WA (2000) Core needle breast biopsy in patients undergoing anticoagulation therapy: preliminary results. AJR Am J Roentgenol. 174:245–9

    CAS  PubMed  Google Scholar 

  32. Sakorafas GH, Tsiotou AG (2000) Ductal carcinoma in situ (dcis) of the breast: evolving perspectives. Cancer Treat Rev. 26:103–25

    CAS  PubMed  Google Scholar 

  33. Burbank F (1997) Stereotactic breast biopsy of atypical ductal hyperplasia and ductal carcinoma in situ lesions: improved accuracy with directional, vacuum-assisted biopsy. Radiology. 202:843–7

    CAS  PubMed  Google Scholar 

  34. Mendez I, Andreu FJ, Saez E et al (2001) Ductal carcinoma in situ and atypical ductal hyperplasia of the breast diagnosed at stereotactic core biopsy. Breast J. 7:14–8

    CAS  PubMed  Google Scholar 

  35. Lee CH, Carter D, Philpotts LE et al (2000) Ductal carcinoma in situ diagnosed with stereotactic core needle biopsy: can invasion be predicted? Radiology. 217:466–70

    CAS  PubMed  Google Scholar 

  36. Liberman L, Dershaw DD, Rosen PP et al (1995) Stereotaxic core biopsy of breast carcinoma: accuracy at predicting invasion. Radiology. 194:379–81

    CAS  PubMed  Google Scholar 

  37. Tavassoli F, Devilee P (2003) World health organization: tumors of the breast and female genital organs. IARC, Lyon, France, p 67

    Google Scholar 

  38. Rosen PP (1997) Intraductal carcinoma; breast pathology. Lippincott-Raven, Philadelphia, pp 227–73

    Google Scholar 

  39. Schwartz GF, Lagios MD, Carter D et al (1997) Consensus conference on the classification of ductal carcinoma in situ. Hum Pathol. 28:1221–5

    Google Scholar 

  40. Silverstein MJ, Poller DN, Waisman JR et al (1995) Prognostic classification of breast ductal carcinoma-in-situ. Lancet. 345:1154–7

    CAS  PubMed  Google Scholar 

  41. Porter DA, Krop IE, Nasser S et al (2001) A sage (serial analysis of gene expression) view of breast tumor progression. Cancer Res. 61:5697–702

    CAS  PubMed  Google Scholar 

  42. Porter D, Lahti-Domenici J, Keshaviah A et al (2003) Molecular markers in ductal carcinoma in situ of the breast. Mol Cancer Res. 1:362–75

    CAS  PubMed  Google Scholar 

  43. Ma XJ, Salunga R, Tuggle JT et al (2003) Gene expression profiles of human breast cancer progression. Proc Natl Acad Sci USA. 100:5974–9

    CAS  PubMed  Google Scholar 

  44. Burstein HJ, Polyak K, Wong JS et al (2004) Ductal carcinoma in situ of the breast. N Engl J Med. 350:1430–41

    CAS  PubMed  Google Scholar 

  45. Page DL, Dupont WD, Rogers LW et al (1982) Intraductal carcinoma of the breast: follow-up after biopsy only. Cancer. 49:751–8

    CAS  PubMed  Google Scholar 

  46. Page DL, Dupont WD, Rogers LW et al (1995) Continued local recurrence of carcinoma 15–25 years after a diagnosis of low-grade ductal carcinoma in situ of the breast treated only by biopsy. Cancer. 76:1197–200

    CAS  PubMed  Google Scholar 

  47. Rosen PP, Braun DW Jr, Kinne DE (1980) The clinical significance of pre-invasive breast carcinoma. Cancer. 46:919–25

    CAS  PubMed  Google Scholar 

  48. Eusebi V, Feudale E, Foschini MP et al (1994) Long-term follow-up of in situ carcinoma of the breast. Semin Diagn Pathol. 11:223–35

    CAS  PubMed  Google Scholar 

  49. Bartow SA, Pathak DR, Black WC et al (1987) Prevalence of benign, atypical and malignant breast lesions in populations at different risk for breast cancer. A forensic autopsy study. Cancer. 60:2751–60

    CAS  PubMed  Google Scholar 

  50. Alpers CE, Wellings SR (1985) The prevalence of carcinoma in situ in normal and cancer-associated breasts. Hum Pathol. 16:796–807

    CAS  PubMed  Google Scholar 

  51. Bhathal PS, Brown RW, Lesueur GC et al (1985) Frequency of benign and malignant breast lesions in 207 consecutive autopsies in Australian women. Br J Cancer. 51:271–8

    CAS  PubMed  Google Scholar 

  52. Kramer WM, Rush BF Jr (1973) Mammary duct proliferation in the elderly. A histopathologic study. Cancer. 31: 130–7

    CAS  PubMed  Google Scholar 

  53. Nielsen M, Thomsen JL, Primdahl S et al (1987) Breast cancer and atypia among young and middle-aged women: a study of 110 medicolegal autopsies. Br J Cancer. 56:814–9

    CAS  PubMed  Google Scholar 

  54. Kauff ND, Brogi E, Scheuer L et al (2003) Epithelial lesions in prophylactic mastectomy specimens from women with BRCA mutations. Cancer. 97:1601–8

    PubMed  Google Scholar 

  55. Hoogerbrugge N, Bult P, de Widt-Levert LM et al (2003) High prevalence of premalignant lesions in prophylactically removed breasts from women at hereditary risk for breast cancer. J Clin Oncol. 21:41–5

    CAS  PubMed  Google Scholar 

  56. Gapstur SM, Morrow M, Sellers TA (1999) Hormone replacement therapy and risk of breast cancer with a favorable histology: results of the Iowa women’s health study. JAMA. 281:2091–7

    CAS  PubMed  Google Scholar 

  57. Kerlikowske K, Barclay J, Grady D et al (1997) Comparison of risk factors for ductal carcinoma in situ and invasive breast cancer. J Natl Cancer Inst. 89:76–82

    CAS  PubMed  Google Scholar 

  58. Claus EB, Stowe M, Carter D (2001) Breast carcinoma in situ: risk factors and screening patterns. J Natl Cancer Inst. 93:1811–7

    CAS  PubMed  Google Scholar 

  59. Warnberg F, Nordgren H, Bergkvist L et al (2001) Tumor markers in breast carcinoma correlate with grade rather than with invasiveness. Br J Cancer. 85:869–74

    CAS  PubMed  Google Scholar 

  60. Zhuang Z, Merino MJ, Chuaqui R et al (1995) Identical allelic loss on chromosome 11q13 in microdissected in situ and invasive human breast cancer. Cancer Res. 55:467–71

    CAS  PubMed  Google Scholar 

  61. O’Sullivan MJ, Morrow M (2007) Ductal carcinoma in situ-current management. Surg Clin North Am. 2007;87:333–51, viii

    PubMed  Google Scholar 

  62. Haagensen C (1971) Diseases of the breast, 2nd edn. WB Saunders, Philadelphia

    Google Scholar 

  63. Kinne DW, Petrek JA, Osborne MP et al (1989) Breast carcinoma in situ. Arch Surg. 124:33–6

    CAS  PubMed  Google Scholar 

  64. Jha MK, Avlonitis VS, Griffith CD et al (2001) Aggressive local treatment for screen-detected DCIS results in very low rates of recurrence. Eur J Surg Oncol. 27:454–8

    CAS  PubMed  Google Scholar 

  65. Ward BA, McKhann CF, Ravikumar TS (1992) Ten-year follow-up of breast carcinoma in situ in Connecticut. Arch Surg. 127:1392–5

    CAS  PubMed  Google Scholar 

  66. Silverstein MJ, Barth A, Poller DN et al (1995) Ten-year results comparing mastectomy to excision and radiation therapy for ductal carcinoma in situ of the breast. Eur J Cancer. 31A:1425–7

    CAS  PubMed  Google Scholar 

  67. Arnesson LG, Smeds S, Fagerberg G et al (1989) Follow-up of two treatment modalities for ductal cancer in situ of the breast. Br J Surg. 76:672–5

    CAS  PubMed  Google Scholar 

  68. Warneke J, Grossklaus D, Davis J et al (1995) Influence of local treatment on the recurrence rate of ductal carcinoma in situ. J Am Coll Surg. 180:683–8

    CAS  PubMed  Google Scholar 

  69. Morrow M, Strom EA, Bassett LW et al (2002) Standard for the management of ductal carcinoma in situ of the breast (DCIS). CA Cancer J Clin. 52:256–76

    PubMed  Google Scholar 

  70. Fisher B, Land S, Mamounas E et al (2001) Prevention of invasive breast cancer in women with ductal carcinoma in situ: an update of the national surgical adjuvant breast and bowel project experience. Semin Oncol. 28:400–18

    CAS  PubMed  Google Scholar 

  71. Bijker N, Meijnen P, Peterse JL et al (2006) Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European organization for research and treatment of cancer randomized phase iii trial 10853—a study by the EORTC breast cancer cooperative group and EORTC radiotherapy group. J Clin Oncol. 24:3381–7

    PubMed  Google Scholar 

  72. Houghton J, George WD, Cuzick J et al (2003) Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK, Australia, and New Zealand: randomized controlled trial. Lancet. 362:95–102

    PubMed  Google Scholar 

  73. Emdin SO, Granstrand B, Ringberg A et al (2006) Swedcis: radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomized trial in a population offered mammography screening. Acta Oncol. 45: 536–43

    PubMed  Google Scholar 

  74. Fisher B, Dignam J, Wolmark N et al (1998) Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from national surgical adjuvant breast and bowel project b-17. J Clin Oncol. 16:441–52

    CAS  PubMed  Google Scholar 

  75. Viani GA, Stefano EJ, Afonso SL et al (2007) Breast-conserving surgery with or without radiotherapy in women with ductal carcinoma in situ: a meta-analysis of randomized trials. Radiat Oncol. 2:28

    PubMed  Google Scholar 

  76. Clarke M, Collins R, Darby S et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomized trials. Lancet. 366:2087–106

    CAS  PubMed  Google Scholar 

  77. Faverly DR, Burgers L, Bult P et al (1994) Three-dimensional imaging of mammary ductal carcinoma in situ: clinical implications. Semin Diagn Pathol. 11:193–8

    CAS  PubMed  Google Scholar 

  78. Neuschatz AC, DiPetrillo T, Steinhoff M et al (2002) The value of breast lumpectomy margin assessment as a predictor of residual tumor burden in ductal carcinoma in situ of the breast. Cancer. 94:1917–24

    PubMed  Google Scholar 

  79. Rodrigues N, Carter D, Dillon D et al (2002) Correlation of clinical and pathologic features with outcome in patients with ductal carcinoma in situ of the breast treated with breast-conserving surgery and radiotherapy. Int J Radiat Oncol Biol Phys. 54:1331–5

    PubMed  Google Scholar 

  80. Nakamura S, Woo C, Silberman H et al (2002) Breast-conserving therapy for ductal carcinoma in situ: a 20-year experience with excision plus radiation therapy. Am J Surg. 184:403–9

    PubMed  Google Scholar 

  81. Dunne C, Burke JP, Morrow M (2009) et al The effect of margin status on the local recurrence following breast conservation and radiation therapy for DCIS. J Clin Oncol. 27:1615–20

    PubMed  Google Scholar 

  82. Solin LJ, Fourquet A, Vicini FA et al (2001) Mammographically detected ductal carcinoma in situ of the breast treated with breast-conserving surgery and definitive breast irradiation: long-term outcome and prognostic significance of patient age and margin status. Int J Radiat Oncol Biol Phys. 50:991–1002

    CAS  PubMed  Google Scholar 

  83. Fisher ER, Dignam J, Tan-Chiu E et al (1999) Pathologic findings from the national surgical adjuvant breast project (nsabp) eight-year update of protocol b-17: intraductal carcinoma. Cancer. 86:429–38

    CAS  PubMed  Google Scholar 

  84. Fisher ER, Land SR, Saad RS et al (2007) Pathologic variables predictive of breast events in patients with ductal carcinoma in situ. Am J Clin Pathol. 128:86–91

    PubMed  Google Scholar 

  85. Silverstein MJ, Lagios MD, Craig PH et al (1996) A prognostic index for ductal carcinoma in situ of the breast. Cancer. 77:2267–74

    CAS  PubMed  Google Scholar 

  86. Provenzano E, Hopper JL, Giles GG et al (2003) Biological markers that predict clinical recurrence in ductal carcinoma in situ of the breast. Eur J Cancer. 39:622–30

    CAS  PubMed  Google Scholar 

  87. Cornfield DB, Palazzo JP, Schwartz GF et al (2004) The prognostic significance of multiple morphologic features and biologic markers in ductal carcinoma in situ of the breast: a study of a large cohort of patients treated with surgery alone. Cancer. 100:2317–27

    PubMed  Google Scholar 

  88. Lagios MD, Margolin FR, Westdahl PR et al (1989) Mammographically detected duct carcinoma in situ. Frequency of local recurrence following tylectomy and prognostic effect of nuclear grade on local recurrence. Cancer. 63:618–24

    CAS  PubMed  Google Scholar 

  89. Silverstein MJ (2002) The Van Nuys/university of Southern California experience by treatment; ductal carcinoma in situ of the breast. Lippincott Williams and Wilkins, Philadelphia, pp 337–42

    Google Scholar 

  90. Silverstein MJ, Lagios MD, Groshen S et al (1999) The influence of margin width on local control of ductal carcinoma in situ of the breast. N Engl J Med. 340:1455–61

    CAS  PubMed  Google Scholar 

  91. Hiramatsu H, Bornstein BA, Recht A et al (1995) Local recurrence after conservative surgery and radiation therapy for ductal carcinoma in situ: possible importance of family history. Cancer J Sci Am. 1:55–61

    CAS  PubMed  Google Scholar 

  92. Macausland SG, Hepel JT, Chong FK et al (2007) An attempt to independently verify the utility of the Van Nuys prognostic index for ductal carcinoma in situ. Cancer. 110: 2648–53

    PubMed  Google Scholar 

  93. Carpenter R, Boulter PS, Cooke T et al (1989) Management of screen detected ductal carcinoma in situ of the female breast. Br J Surg. 76:564–7

    CAS  PubMed  Google Scholar 

  94. Schwartz GF, Finkel GC, Garcia JC et al (1992) Subclinical ductal carcinoma in situ of the breast. Treatment by local excision and surveillance alone. Cancer. 70:2468–74

    CAS  PubMed  Google Scholar 

  95. Kestin LL, Goldstein NS, Martinez AA et al (2000) Mammographically detected ductal carcinoma in situ treated with conservative surgery with or without radiation therapy: patterns of failure and 10-year results. Ann Surg. 231:235–45

    CAS  PubMed  Google Scholar 

  96. Sanders ME, Schuyler PA, Dupont WD et al (2005) The naturaly history of low-grade ductal carcinoma in situ of the breast in women treated by biopsy only revealed over 30 years of long-term follow-up. Cancer. 103:2481–4

    PubMed  Google Scholar 

  97. Wong JS, Kaelin CM, Troyan SL et al (2006) Prospective study of wide excision alone for ductal carcinoma in situ of the breast. J Clin Oncol. 24:1031–6

    PubMed  Google Scholar 

  98. Hughes L, Wang M, Page DL et al Local excision alone without irradiation for ductal carcinoma in situ of the breast: a trial of Eastern Cooperative Oncology Group. J Clin Oncol. (in press)

    Google Scholar 

  99. Winchester DP, Menck HR, Osteen RT et al (1995) Treatment trends for ductal carcinoma in situ of the breast. Ann Surg Oncol. 2:207–13

    CAS  PubMed  Google Scholar 

  100. Silverstein MJ, Rosser RJ, Gierson ED et al (1987) Axillary lymph node dissection for intraductal breast carcinoma—is it indicated? Cancer. 59:1819–24

    CAS  PubMed  Google Scholar 

  101. Solin LJ, Kurtz J, Fourquet A et al (1996) Fifteen-year results of breast-conserving surgery and definitive breast irradiation for the treatment of ductal carcinoma in situ of the breast. J Clin Oncol. 14:754–63

    CAS  PubMed  Google Scholar 

  102. Klauber-DeMore N, Tan LK, Liberman L et al (2000) Sentinel lymph node biopsy: is it indicated in patients with high-risk ductal carcinoma-in-situ and ductal carcinoma-in-situ with microinvasion? Ann Surg Oncol. 7:636–42

    CAS  PubMed  Google Scholar 

  103. Pendas S, Dauway E, Giuliano R et al (2000) Sentinel node biopsy in ductal carcinoma in situ patients. Ann Surg Oncol. 7:15–20

    CAS  PubMed  Google Scholar 

  104. Lara JF, Young SM, Velilla RE et al (2003) The relevance of occult axillary micrometastasis in ductal carcinoma in situ: a clinicopathologic study with long-term follow-up. Cancer. 98:2105–13

    PubMed  Google Scholar 

  105. Julian TB, Land SR, Fourchotte V et al (2007) Is sentinel node biopsy necessary in conservatively treated DCIS? Ann Surg Oncol. 14:2202–8

    PubMed  Google Scholar 

  106. Fisher B, Dignam J, Wolmark N et al (1999) Tamoxifen in treatment of intraductal breast cancer: national surgical adjuvant breast and bowel project b-24 randomized controlled trial. Lancet. 353:1993–2000

    CAS  PubMed  Google Scholar 

  107. Wilke LG, McCall LM, Posther KE et al (2006) Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. Ann Surg Oncol. 13:491–500

    PubMed  Google Scholar 

  108. Dunn BK, Wickerham DL, Ford LG (2005) Prevention of hormone-related cancers: breast cancer. J Clin Oncol. 23:357–67

    PubMed  Google Scholar 

  109. Anon (1998) Tamoxifen for early breast cancer: an overview of the randomised trials. Early breast cancer trialists’ collaborative group. Lancet. 351:1451–67

    Google Scholar 

  110. Fisher B, Bryant J, Dignam JJ et al (2002) Tamoxifen, radiation therapy or both for prevention of ipsilateral breast tumor recurrence after lumpectomy in women with invasive breast cancers of one centimeter or less. J Clin Oncol. 20:4141–9

    CAS  PubMed  Google Scholar 

  111. Allred D, Bryant J, Land S et al (2002) Estrogen receptor expression as a predictive marker of the effectiveness of tamoxifen in the treatment of DCIS: findings from NSABP b-24. Breast Cancer Res Treat. 76:S36

    Google Scholar 

  112. Dignam JJ, Fisher B (2000) Occurrence of stroke with tamoxifen in NSABP b-24. Lancet. 355:848–9

    CAS  PubMed  Google Scholar 

  113. Baum M, Buzdar A, Cuzick J et al (2003) Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (arimidex, tamoxifen alone or in combination) trial efficacy and safety update analyses. Cancer. 98:1802–10

    CAS  PubMed  Google Scholar 

  114. Coates AS, Keshaviah A, Thurlimann B et al (2007) Five years of letrozole compared with tamoxifen as initial adjuvant therapy for postmenopausal women with endocrine-responsive early breast cancer: update of study big 1–98. J Clin Oncol. 25:486–92

    CAS  PubMed  Google Scholar 

  115. Goss PE (2003) Emerging role of aromatase inhibitors in the adjuvant setting. Am J Clin Oncol. 26:S27–33

    Google Scholar 

  116. NSABP. Clinical trials overview web site. Pittsburgh, PA; 2007

    Google Scholar 

  117. International breast cancer intervention study-ii web site: IBIS Trials; 2007

    Google Scholar 

  118. Morrow M, Bucci C, Rademaker A (1998) Medical contraindications are not a major factor in the underutilization of breast conserving therapy. J Am Coll Surg. 186:269–74

    CAS  PubMed  Google Scholar 

  119. Patchefsky AS, Schwartz GF, Finkelstein SD et al (1989) Heterogeneity of intraductal carcinoma of the breast. Cancer. 63:731–41

    CAS  PubMed  Google Scholar 

  120. Bauer RL, Eckhert KH Jr, Nemoto T (1998) Ductal carcinoma in situ-associated nipple discharge: a clinical marker for locally extensive disease. Ann Surg Oncol. 5:452–5

    CAS  PubMed  Google Scholar 

  121. Yen TW, Kuerer HM, Ottesen RA et al (2007) Impact of randomized clinical trial results in the national comprehensive cancer network on the use of tamoxifen after breast surgery for ductal carcinoma in situ. J Clin Oncol. 25:3251–8

    CAS  PubMed  Google Scholar 

  122. O’Sullivan MJ, Li T, Freedman G et al (2007) The effect of multiple reexcisions on the risk of local recurrence after breast conserving surgery. Ann Surg Oncol. 14:3133–40

    PubMed  Google Scholar 

  123. Katz SJ, Lantz PM, Janz NK et al (2005) Patient involvement in surgery treatment decisions for breast cancer. J Clin Oncol. 23:5526–33

    PubMed  Google Scholar 

  124. Katz SJ, Lantz PM, Janz NK et al (2005) Patterns and correlates of local therapy for women with ductal carcinoma-in-situ. J Clin Oncol. 23:3001–7

    PubMed  Google Scholar 

  125. Fowble B, Hanlon AL, Fein DA et al (1997) Results of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS). Int J Radiat Oncol Biol Phys. 38:949–57

    CAS  PubMed  Google Scholar 

  126. Ashkanani F, Sarkar T, Needham G et al (2001) What is achieved by mammographic surveillance after breast conservation treatment for breast cancer? Am J Surg. 182:207–10

    CAS  PubMed  Google Scholar 

  127. Dershaw DD (1995) Mammography in patients with breast cancer treated by breast conservation (lumpectomy with or without radiation). AJR Am J Roentgenol. 164:309–16

    CAS  PubMed  Google Scholar 

  128. Dershaw DD, Shank B, Reisinger S (1987) Mammographic findings after breast cancer treatment with local excision and definitive irradiation. Radiology. 164:455–61

    CAS  PubMed  Google Scholar 

  129. Mendelson EB (1992) Evaluation of the postoperative breast. Radiol Clin North Am. 30:107–38

    CAS  PubMed  Google Scholar 

  130. Dershaw DD, McCormick B, Osborne MP (1992) Detection of local recurrence after conservative therapy for breast carcinoma. Cancer. 70:493–6

    CAS  PubMed  Google Scholar 

  131. Saslow D, Boetes C, Burke W et al (2007) American cancer society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 57:75–89

    PubMed  Google Scholar 

  132. Lagios MD (1990) Duct carcinoma in situ. Pathology and treatment. Surg Clin North Am. 70:853–71

    CAS  PubMed  Google Scholar 

  133. Cutuli B, Teissier E, Piat JM et al (1992) Radical surgery and conservative treatment of ductal carcinoma in situ of the breast. Eur J Cancer. 28:649–54

    CAS  PubMed  Google Scholar 

  134. Solin LJ, Fourquet A, Vicini FA et al (2005) Salvage treatment for local or local-regional recurrence after initial breast conservation treatment with radiation for ductal carcinoma in situ. Eur J Cancer. 41:1715–23

    PubMed  Google Scholar 

  135. Graham MD, Lakhani S, Gazet JC (1991) Breast conserving surgery in the management of in situ breast carcinoma. Eur J Surg Oncol. 17:258–64

    CAS  PubMed  Google Scholar 

  136. Deutsch M (2002) Repeat high-dose external beam irradiation for in-breast tumor recurrence after previous lumpectomy and whole breast irradiation. Int J Radiat Oncol Biol Phys. 53:687–91

    PubMed  Google Scholar 

  137. Kim JH, Tavassoli F, Haffty BG (2006) Chest wall relapse after mastectomy for ductal carcinoma in situ: a report of 10 cases with a review of the literature. Cancer J. 12:92–101

    PubMed  Google Scholar 

  138. Lee LA, Silverstein MJ, Chung CT et al (2006) Breast cancer-specific mortality after invasive local recurrence in patients with ductal carcinoma-in-situ of the breast. Am J Surg. 192:416–9

    PubMed  Google Scholar 

  139. Port ER, Garcia-Etienne CA, Park J et al (2007) Reoperative sentinel lymph node biopsy: a new frontier in the management of ipsilateral breast tumor recurrence. Ann Surg Oncol. 14:2209–14

    PubMed  Google Scholar 

  140. Intra M, Trifiro G, Viale G et al (2005) Second biopsy of axillary sentinel lymph node for reappearing breast cancer after previous sentinel lymph node biopsy. Ann Surg Oncol. 12:895–9

    PubMed  Google Scholar 

  141. Barone JL, Feldman SM, Estabrook A et al (2007) Reoperative sentinel lymph node biopsy in patients with locally recurrent breast cancer. Am J Surg. 194:491–3

    PubMed  Google Scholar 

  142. Roumen RM, Kuijt GP, Liem IH (2006) Lymphatic mapping and sentinel node harvesting in patients with recurrent breast cancer. Eur J Surg Oncol. 32:1076–81

    CAS  PubMed  Google Scholar 

  143. Port ER, Fey J, Gemignani ML et al (2002) Reoperative sentinel lymph node biopsy: a new option for patients with primary or locally recurrent breast carcinoma. J Am Coll Surg. 195:167–72

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19115, USA

    Robin M. Ciocca

  2. Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, 1275, York Avenue, MRI 1026, New York, NY, 10021, USA

    Monica Morrow

Authors
  1. Robin M. Ciocca
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Monica Morrow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Monica Morrow .

Editor information

Editors and Affiliations

  1. Breast Care Center National Naval Medical Center, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD, 20814, USA

    Ismail Jatoi (Head) (Head)

  2. Women’s Hospital, University of Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany

    Manfred Kaufmann (Breast Unit Director) (Breast Unit Director)

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Ciocca, R.M., Morrow, M. (2010). Ductal Carcinoma in Situ. In: Jatoi, I., Kaufmann, M. (eds) Management of Breast Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69743-5_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-69743-5_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-69742-8

  • Online ISBN: 978-3-540-69743-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation