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[Ductal carcinomas in situ].

Anne de Roquancourt1, Paul-Henry Cottu, Caroline Cuvier

  • 1Anatomopathologie, Centre des Maladies du Sein, Oncologie Médicale, Hôpital Saint Louis, Paris. .

Presse Medicale (Paris, France : 1983)
|March 1, 2003
PubMed
Summary

Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer often detected by micro-calcifications on mammography. Diagnosis and treatment involve surgical biopsy, with options ranging from mastectomy to conservative excision, depending on the individual case.

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Area of Science:

  • Oncology
  • Radiology
  • Pathology

Background:

  • Ductal carcinoma in situ (DCIS) accounts for 15-30% of new breast cancer cases, typically affecting women aged 49-54.
  • DCIS is characterized by its non-invasive nature, confined within the milk ducts, and distinct histological features differentiating it from lobular carcinoma in situ.
  • These lesions are heterogeneous, varying in morphology, histology, and progression potential.

Purpose of the Study:

  • To outline the diagnostic approaches for ductal carcinoma in situ (DCIS).
  • To discuss the therapeutic modalities available for DCIS, emphasizing the balance between cure and treatment consequences.
  • To highlight the importance of complete micro-calcification excision in conservative management.

Main Methods:

  • Diagnosis is primarily evoked by micro-calcifications identified on mammography.

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  • For isolated micro-calcifications, surgical biopsy following radiological localization is the preferred method.
  • Needle micro-biopsy and macro-biopsies with stereotactic localization are employed for tissue collection and excision.

    • Main Results:

    • Surgical biopsy is crucial for diagnosing DCIS, especially when micro-calcifications are present.
    • Conservative treatment is feasible if micro-calcifications are completely excised with clear margins (≥10 mm).
    • Mastectomy remains an option for specific cases, while post-surgical treatment recommendations (monitoring, irradiation, tamoxifen) lack consensus.

    Conclusions:

    • Accurate diagnosis of DCIS relies on mammographic detection of micro-calcifications and subsequent histological examination via biopsy.
    • Treatment decisions for DCIS prioritize maximizing cure rates while minimizing therapeutic impact, with surgical excision being a key component.
    • Further research is needed to establish definitive post-operative management guidelines for DCIS.