Ductal Carcinoma in Situ: State-of-the-Art Review.

Journal Article (Journal Article;Review)

Ductal carcinoma in situ (DCIS) is a nonobligate precursor of invasive cancer, and its detection, diagnosis, and management are controversial. DCIS incidence grew with the expansion of screening mammography programs in the 1980s and 1990s, and DCIS is viewed as a major driver of overdiagnosis and overtreatment. For pathologists, the diagnosis and classification of DCIS is challenging due to undersampling and interobserver variability. Understanding the progression from normal breast tissue to DCIS and, ultimately, to invasive cancer is limited by a paucity of natural history data with multiple proposed evolutionary models of DCIS initiation and progression. Although radiologists are familiar with the classic presentation of DCIS as asymptomatic calcifications at mammography, the expanded pool of modalities, advanced imaging techniques, and image analytics have identified multiple potential biomarkers of histopathologic characteristics and prognosis. Finally, there is growing interest in the nonsurgical management of DCIS, including active surveillance, to reduce overtreatment and provide patients with more personalized management options. However, current biomarkers are not adept at enabling identification of occult invasive disease at biopsy or accurately predicting the risk of progression to invasive disease. Several active surveillance trials are ongoing and are expected to better identify women with low-risk DCIS who may avoid surgery.

Full Text

Duke Authors

Cited Authors

  • Grimm, LJ; Rahbar, H; Abdelmalak, M; Hall, AH; Ryser, MD

Published Date

  • February 2022

Published In

Volume / Issue

  • 302 / 2

Start / End Page

  • 246 - 255

PubMed ID

  • 34931856

Pubmed Central ID

  • PMC8805655

Electronic International Standard Serial Number (EISSN)

  • 1527-1315

Digital Object Identifier (DOI)

  • 10.1148/radiol.211839

Language

  • eng

Conference Location

  • United States