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

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 radiothera...

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Autores principales: van Seijen, Maartje, Lips, Esther H., Thompson, Alastair M., Nik-Zainal, Serena, Futreal, Andrew, Hwang, E. Shelley, Verschuur, Ellen, Lane, Joanna, Jonkers, Jos, Rea, Daniel W., Wesseling, Jelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697179/
https://www.ncbi.nlm.nih.gov/pubmed/31285590
http://dx.doi.org/10.1038/s41416-019-0478-6
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author van Seijen, Maartje
Lips, Esther H.
Thompson, Alastair M.
Nik-Zainal, Serena
Futreal, Andrew
Hwang, E. Shelley
Verschuur, Ellen
Lane, Joanna
Jonkers, Jos
Rea, Daniel W.
Wesseling, Jelle
author_facet van Seijen, Maartje
Lips, Esther H.
Thompson, Alastair M.
Nik-Zainal, Serena
Futreal, Andrew
Hwang, E. Shelley
Verschuur, Ellen
Lane, Joanna
Jonkers, Jos
Rea, Daniel W.
Wesseling, Jelle
author_sort van Seijen, Maartje
collection PubMed
description 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.
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spelling pubmed-66971792019-08-16 Ductal carcinoma in situ: to treat or not to treat, that is the question van Seijen, Maartje Lips, Esther H. Thompson, Alastair M. Nik-Zainal, Serena Futreal, Andrew Hwang, E. Shelley Verschuur, Ellen Lane, Joanna Jonkers, Jos Rea, Daniel W. Wesseling, Jelle Br J Cancer Review Article 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. Nature Publishing Group UK 2019-07-09 2019-08-13 /pmc/articles/PMC6697179/ /pubmed/31285590 http://dx.doi.org/10.1038/s41416-019-0478-6 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review Article
van Seijen, Maartje
Lips, Esther H.
Thompson, Alastair M.
Nik-Zainal, Serena
Futreal, Andrew
Hwang, E. Shelley
Verschuur, Ellen
Lane, Joanna
Jonkers, Jos
Rea, Daniel W.
Wesseling, Jelle
Ductal carcinoma in situ: to treat or not to treat, that is the question
title Ductal carcinoma in situ: to treat or not to treat, that is the question
title_full Ductal carcinoma in situ: to treat or not to treat, that is the question
title_fullStr Ductal carcinoma in situ: to treat or not to treat, that is the question
title_full_unstemmed Ductal carcinoma in situ: to treat or not to treat, that is the question
title_short Ductal carcinoma in situ: to treat or not to treat, that is the question
title_sort ductal carcinoma in situ: to treat or not to treat, that is the question
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697179/
https://www.ncbi.nlm.nih.gov/pubmed/31285590
http://dx.doi.org/10.1038/s41416-019-0478-6
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