TITLE:
Ductal Carcinoma in Situ Treatment Requires a Multidisciplinary Approach
AUTHORS:
Chloe Constantinou, Ian S. Fentiman
KEYWORDS:
Ductal Carcinoma in Situ; Epidemiology; Molecular Profile; Surgery; Radiotherapy; Tamoxifen
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.4 No.7,
August
26,
2013
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 .