Current management of DCIS: a review

Area of Science:

• Oncology
• Breast Cancer Research

Background:

• Ductal carcinoma in-situ (DCIS) exhibits significant heterogeneity in imaging, histology, and molecular features.
• This variability impacts its natural history and optimal management strategies.
• A subset of DCIS lesions may not progress to invasive disease, suggesting potential for de-escalated treatment.

Purpose of the Study:

• To review current management strategies for DCIS.
• To explore the role of emerging approaches like biological profiling and molecular analysis in understanding DCIS tumor biology.
• To contextualize these strategies within recent randomized trials.

Main Methods:

• Review of recent randomized clinical trials concerning DCIS management.
• Discussion of diagnostic and prognostic markers, including molecular profiling.
• Analysis of treatment modalities such as sentinel lymph node biopsy, radiotherapy, and tamoxifen.

Main Results:

• DCIS is a heterogeneous condition with variable clinical behavior.
• Identifying patients with low-risk DCIS could enable less aggressive or omitted treatment.
• Multidisciplinary team input and personalized management are crucial.

Conclusions:

• Tailoring DCIS management based on individual risk is essential.
• Biological profiling and molecular analysis offer promise for refining treatment rationales.
• Evidence from recent trials informs decisions on sentinel lymph node biopsy, radiotherapy, and tamoxifen.