Ductal Carcinoma In Situ: Controversies in Diagnosis, Biology, and Treatment

摘要: : A clinically relevant classification and understanding of the biology ductal carcinoma in situ (DCIS) is mandated by increasing numbers mammographically detected lesions limited size being considered for breast-conserving therapy. DCIS a morphologically biologically diverse assemblage that are conventionally classified an arbitrary largely descriptive manner based on architectural features. Several classifications nuclear grade necrosis have been shown to stratify into subtypes associated with vastly different risks local recurrence invasive transformation. Breast-conserving therapy dependent adequate surgical excision, even more so than breast carcinomas, but procedure itself made difficult ability define pathologic extent lesion basis mammographic microcalcification, vagaries localization procedure, multifocal nature some subtypes. Proper tissue processing interpretation, particularly regard presence or misinterpretation microinvasion, all affect success therapy. Irradiation would appear no role treatment low adequately excised. The benefits irradiation be high benefit diminishes follow-up. Irradiation not likely control patients significant residual disease who undergo