Low-risk DCIS. What is it? Observe or excise?

The issue of overdiagnosis and overtreatment of lesions detected by breast screening mammography has been debated in both international media and the scientific literature. A proportion of cancers detected by breast screening would never have presented symptomatically or caused harm during the patie...

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Autores principales: Pinder, Sarah E., Thompson, Alastair M., Wesserling, Jelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Review
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8983540/
https://www.ncbi.nlm.nih.gov/pubmed/34448893
http://dx.doi.org/10.1007/s00428-021-03173-8
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author Pinder, Sarah E.
Thompson, Alastair M.
Wesserling, Jelle
author_facet Pinder, Sarah E.
Thompson, Alastair M.
Wesserling, Jelle
author_sort Pinder, Sarah E.
collection PubMed
description The issue of overdiagnosis and overtreatment of lesions detected by breast screening mammography has been debated in both international media and the scientific literature. A proportion of cancers detected by breast screening would never have presented symptomatically or caused harm during the patient’s lifetime. The most likely (but not the only) entity which may represent those overdiagnosed and overtreated is low-grade ductal carcinoma in situ (DCIS). In this article, we address what is understood regarding the natural history of DCIS and the diagnosis and prognosis of low-grade DCIS. However, low cytonuclear grade disease may not be the totality of DCIS that can be considered of low clinical risk and we outline the issues regarding active surveillance vs excision of low-risk DCIS and the clinical trials exploring this approach.
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spelling pubmed-89835402022-04-22 Low-risk DCIS. What is it? Observe or excise? Pinder, Sarah E. Thompson, Alastair M. Wesserling, Jelle Virchows Arch Review The issue of overdiagnosis and overtreatment of lesions detected by breast screening mammography has been debated in both international media and the scientific literature. A proportion of cancers detected by breast screening would never have presented symptomatically or caused harm during the patient’s lifetime. The most likely (but not the only) entity which may represent those overdiagnosed and overtreated is low-grade ductal carcinoma in situ (DCIS). In this article, we address what is understood regarding the natural history of DCIS and the diagnosis and prognosis of low-grade DCIS. However, low cytonuclear grade disease may not be the totality of DCIS that can be considered of low clinical risk and we outline the issues regarding active surveillance vs excision of low-risk DCIS and the clinical trials exploring this approach. Springer Berlin Heidelberg 2021-08-27 2022 /pmc/articles/PMC8983540/ /pubmed/34448893 http://dx.doi.org/10.1007/s00428-021-03173-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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 licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence 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 licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review
Pinder, Sarah E.
Thompson, Alastair M.
Wesserling, Jelle
Low-risk DCIS. What is it? Observe or excise?
title Low-risk DCIS. What is it? Observe or excise?
title_full Low-risk DCIS. What is it? Observe or excise?
title_fullStr Low-risk DCIS. What is it? Observe or excise?
title_full_unstemmed Low-risk DCIS. What is it? Observe or excise?
title_short Low-risk DCIS. What is it? Observe or excise?
title_sort low-risk dcis. what is it? observe or excise?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8983540/
https://www.ncbi.nlm.nih.gov/pubmed/34448893
http://dx.doi.org/10.1007/s00428-021-03173-8
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