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Related Experiment Video

Updated: Oct 22, 2025

Intraductal Delivery to the Rabbit Mammary Gland
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Low-risk DCIS. What is it? Observe or excise?

Sarah E Pinder1, Alastair M Thompson2, Jelle Wesserling3

  • 1School of Cancer & Pharmaceutical Sciences, King's College London, Comprehensive Cancer Centre At Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK. sarah.pinder@kcl.ac.uk.

Virchows Archiv : an International Journal of Pathology
|August 27, 2021
PubMed
Summary

Overdiagnosis in breast cancer screening may involve low-grade ductal carcinoma in situ (DCIS) that would not have caused harm. Research explores active surveillance versus surgical excision for low-risk DCIS.

Keywords:
Ductal carcinoma in situPrognosisSurveillance mammography

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Area of Science:

  • Oncology
  • Radiology
  • Pathology

Background:

  • Breast screening mammography detects lesions, raising concerns about overdiagnosis and overtreatment.
  • A subset of detected cancers may never become clinically significant or life-threatening.

Purpose of the Study:

  • To review the natural history, diagnosis, and prognosis of low-grade ductal carcinoma in situ (DCIS).
  • To discuss active surveillance versus excision for low-risk DCIS and ongoing clinical trials.

Main Methods:

  • Literature review and synthesis of current understanding of DCIS.
  • Analysis of diagnostic criteria and prognostic factors for low-grade DCIS.
  • Examination of the evidence for active surveillance strategies.

Main Results:

  • Low-grade DCIS is a potential contributor to overdiagnosis and overtreatment in breast cancer screening.
  • Not all low-grade DCIS may represent the full spectrum of clinically low-risk disease.
  • Active surveillance is being explored as an alternative to surgical excision for select cases.

Conclusions:

  • Careful consideration of the natural history and risk stratification of DCIS is crucial.
  • Further research and clinical trials are needed to establish optimal management for low-risk DCIS.
  • Balancing the benefits of early detection with the risks of overdiagnosis is essential in breast cancer screening.