How to Navigate the Treatment Spectrum from Multimodality Therapy to Observation Alone for ductal carcinoma in situ

Surg Oncol Clin N Am. 2023 Oct;32(4):663-673. doi: 10.1016/j.soc.2023.05.011. Epub 2023 Jun 15.

Abstract

DCIS detection has increased dramatically since the introduction of screening mammography. Current guidance concordant care recommends surgical intervention for all patients with DCIS, followed by radiation and/or endocrine therapy for some. Adjuvant therapies after surgical excision have reduced recurrence rates but not breast cancer mortality. Given the lack of evidence of current treatment regimens and the morbidity associated with these treatments, there is concern that DCIS is over-treated. Active surveillance may be a favorable alternative for selected patients and is currently being investigated through four international clinical trials.

Keywords: Active surveillance; DCIS; De-escalation; Over-treatment.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Breast Neoplasms* / therapy
  • Carcinoma, Intraductal, Noninfiltrating* / therapy
  • Combined Modality Therapy
  • Early Detection of Cancer
  • Female
  • Humans
  • Mammography