Abstract
Correct diagnosis and treatment are crucial for DCIS because it is a direct precursor of potentially lethal invasive breast cancer (IBC). As a result of mammographic screening, the incidence of DCIS rose from 1.87% per 100,000 women from 1973-1975 to 32.5% per 100,000 in 2005. The incidence of DCIS is strongly associated with advanced age, an older age at the time of the first birth or nulliparity, family history of a first-degree relative with BC, BRCA1 and BRCA2 mutation carriers, history of biopsy, late age at menopause, and elevated body mass index, the use of HRT over 5 years. With the use of screening mammography, eight population-based trials showed an increase in DCIS incidence reaching 20% with significant reductions in breast cancer mortality. MRI is also used in combination with the mammography for the diagnosis of DCIS. Three grades of DCIS are ultimately recognized: grade 1/low grade, grade 2/intermediate grade, and grade 3/high grade. Several options are available for the management of DCIS, including breast-conserving surgery, with or without postoperative radiotherapy, and with the clear margin being the most important factor for reducing risk of local recurrence. A 2 mm margin is superior to .
Highlights
The human breast comprises thousands of lobules, interconnected by small ducts, which join to form larger ducts that carry milk to the nipple
A 2 mm margin is superior to
In a study of 236 Ductal Carcinoma in Situ (DCIS) patients treated with breast-conserving surgery, Knudsen et al [79] examined the association of two major tumour suppressor genes—retinoblastoma (RB) and phosphatase and tensin homolog (PTEN)—and the risk for ipsilateral breast event (IBE) or progression to invasive breast cancer (IBC)
Summary
The human breast comprises thousands of lobules, interconnected by small ducts, which join to form larger ducts that carry milk to the nipple. Ductal Carcinoma in Situ (DCIS) describes lesions characterised by the proliferation of abnormal epithelial cells but without evidence of invasion through the basement membrane into the surrounding stroma. Correct diagnosis and treatment are essential since DCIS is a direct precursor of potentially lethal invasive breast cancer (IBC). Ter half of the 20th century, as a result of early diagnosis by screening mammography and results of several randomized controlled trials (RCTs) of therapies for DCIS there was a change in perception of the nature and treatment of DCIS [1,2,3,4,5,6,7,8,9,10]
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