Ductal carcinoma in situ: to treat or not to treat, that is the question.


Journal

British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635

Informations de publication

Date de publication:
08 2019
Historique:
received: 14 03 2018
accepted: 22 03 2019
revised: 19 03 2019
pubmed: 10 7 2019
medline: 11 3 2020
entrez: 10 7 2019
Statut: ppublish

Résumé

Ductal carcinoma in situ (DCIS) now represents 20-25% of all 'breast cancers' consequent upon detection by population-based breast cancer screening programmes. Currently, all DCIS lesions are treated, and treatment comprises either mastectomy or breast-conserving surgery supplemented with radiotherapy. However, most DCIS lesions remain indolent. Difficulty in discerning harmless lesions from potentially invasive ones can lead to overtreatment of this condition in many patients. To counter overtreatment and to transform clinical practice, a global, comprehensive and multidisciplinary collaboration is required. Here we review the incidence of DCIS, the perception of risk for developing invasive breast cancer, the current treatment options and the known molecular aspects of progression. Further research is needed to gain new insights for improved diagnosis and management of DCIS, and this is integrated in the PRECISION (PREvent ductal Carcinoma In Situ Invasive Overtreatment Now) initiative. This international effort will seek to determine which DCISs require treatment and prevent the consequences of overtreatment on the lives of many women affected by DCIS.

Identifiants

pubmed: 31285590
doi: 10.1038/s41416-019-0478-6
pii: 10.1038/s41416-019-0478-6
pmc: PMC6697179
mid: EMS83733
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

285-292

Subventions

Organisme : Cancer Research UK (CRUK)
ID : C38317/A24043
Pays : International

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Auteurs

Maartje van Seijen (M)

Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Esther H Lips (EH)

Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Alastair M Thompson (AM)

Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA.

Serena Nik-Zainal (S)

Department of Medical Genetics, University of Cambridge, Cambridge, UK.

Andrew Futreal (A)

Department of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

E Shelley Hwang (ES)

Department of Surgery, Duke University Comprehensive Cancer Center, Durham, NC, USA.

Ellen Verschuur (E)

Borstkankervereniging Nederland, Utrecht, The Netherlands.

Joanna Lane (J)

Health Cluster Net, Amsterdam, The Netherlands.

Jos Jonkers (J)

Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Oncode Institute, Amsterdam, The Netherlands.

Daniel W Rea (DW)

Department of Medical Oncology, University of Birmingham, Birmingham, UK.

Jelle Wesseling (J)

Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. j.wesseling@nki.nl.
Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. j.wesseling@nki.nl.
Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands. j.wesseling@nki.nl.

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