Intraductal noninvasive breast cancer: a comparison of three local treatments

In selecting appropriate local treatment for intraductal noninvasive breast cancer, the following factors should be considered: Method of detection (palpable mass vs mammographic finding only vs incidental finding at biopsy for a benign lesion), the size and extent of the tumor, margins of resection, and the histologic pattern. Mastectomy is recommended for extensive tumors, and for patients with gross multicentric disease. Conservative surgery and radiation is an alternative for patients with focal lesions, negative margins of resection, and no evidence of residual microcalcifications on a post-biopsy mammogram. Consideration of wide excision alone should be restricted to those with occult primary tumors less than or equal to 2.5 cm in size, detected by mammographic microcalcifications only, and where complete excision is confirmed. The histologic subtype or nuclear grade may be especially important in evaluating patients for wide excision alone.