Ductal carcinoma in situ: to treat or not to treat, that is the question.

Journal Article (Journal Article;Review)

Ductal carcinoma in situ (DCIS) now represents 20-25% of all 'breast cancers' consequent upon detection by population-based breast cancer screening programmes. Currently, all DCIS lesions are treated, and treatment comprises either mastectomy or breast-conserving surgery supplemented with radiotherapy. However, most DCIS lesions remain indolent. Difficulty in discerning harmless lesions from potentially invasive ones can lead to overtreatment of this condition in many patients. To counter overtreatment and to transform clinical practice, a global, comprehensive and multidisciplinary collaboration is required. Here we review the incidence of DCIS, the perception of risk for developing invasive breast cancer, the current treatment options and the known molecular aspects of progression. Further research is needed to gain new insights for improved diagnosis and management of DCIS, and this is integrated in the PRECISION (PREvent ductal Carcinoma In Situ Invasive Overtreatment Now) initiative. This international effort will seek to determine which DCISs require treatment and prevent the consequences of overtreatment on the lives of many women affected by DCIS.

Full Text

Duke Authors

Cited Authors

  • van Seijen, M; Lips, EH; Thompson, AM; Nik-Zainal, S; Futreal, A; Hwang, ES; Verschuur, E; Lane, J; Jonkers, J; Rea, DW; Wesseling, J; PRECISION team,

Published Date

  • August 2019

Published In

Volume / Issue

  • 121 / 4

Start / End Page

  • 285 - 292

PubMed ID

  • 31285590

Pubmed Central ID

  • PMC6697179

Electronic International Standard Serial Number (EISSN)

  • 1532-1827

Digital Object Identifier (DOI)

  • 10.1038/s41416-019-0478-6


  • eng

Conference Location

  • England