Now, later of never: multicenter randomized controlled trial call--is surgery necessary after atypical breast core biopsy results in mammographic screening settings?

Int J Surg Oncol. 2015;2015:192579. doi: 10.1155/2015/192579. Epub 2015 Apr 21.

Abstract

Breast cancer mammographic screening leads to detection of premalignant and preinvasive lesions with an increasing frequency. Nevertheless, current epidemiologic evidence indicates that the screening reduces breast cancer specific mortality, but not overall mortality in breast cancer patients. The evidence is lacking whether aggressive eradication of DCIS (preinvasive form of breast carcinoma) by surgery and radiation is of survival benefit, as long-term breast cancer specific mortality in a cohort of patients with DCIS is already in a single digit percent range. Furthermore, it is currently not known whether the aggressive surgical eradication of atypical breast lesions which fall short of diagnosis of DCIS is of any benefit for the patients. Here we propose a model for a randomized controlled trial to generate high level evidence and solve this dilemma.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Biopsy, Large-Core Needle
  • Breast / pathology*
  • Breast / surgery
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / surgery
  • Clinical Protocols
  • Early Detection of Cancer* / methods
  • Female
  • Humans
  • Mammography*
  • Mastectomy*
  • Middle Aged
  • Watchful Waiting