Carcinoma in situ: a review

Abstract

Ductal carcinoma in situ (DCIS) is a biologically and morphologically heterogeneous disease. The incidence of DCIS is increasing mainly due to programs of screening mammography, which result in increased diagnosis of the disease in asymptomatic patients. The most common finding is of calcifications on mammography. When treated appropriately, the prognosis of DCIS is excellent. Optimal treatment for DCIS, however, remains controversial. The objective of the treatment of patients with DCIS is to control the local disease and prevent subsequent development of invasive cancer. Mastectomy probably represents an aggressive approach in a substantial number of patients, especially those with small, mammographically detected lesions. There is evidence that breast conservation therapy is an effective alternative in the handling of patients with DCIS. The use of radiotherapy after lumpectomy significantly decreases the risk for local recurrence. If the patient and her surgeon are in agreement about using breast conservation therapy, it is necessary to understand incidence and implications of local recurrence. Moreover, it is also important to underscore the excellent prognosis independently of the surgical approach used.