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Current Management of Patients with Ductal Carcinoma-in-Situ

^a Joint Center For Radiation Therapy and ^b Beth Israel Hospital Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA

Correspondence: Jay Harris, M.D., Harvard Joint Center for Radiation Therapy, Harvard Medical School, 330 Brookline Avenue, Boston, Massachusetts 02115, USA. Telephone: 617-667-9550; Fax: 617-667-4681.

Because of the wider use of screening mammography, ductal carcinoma-in-situ, or DCIS, once rare, is now diagnosed with increasing frequency. Important questions remain unresolved regarding the natural history, classification, and management of DCIS. Many physicians have assumed that DCIS is diffuse and regularly progresses to invasive cancer; therefore, they routinely recommend mastectomy. However, as we learn more about this lesion, it is now clear that in many cases the lesion is focal in extent, "premalignant," and curable with local procedures short of mastectomy. In this review, we describe the current state of knowledge regarding the presentation, pathology, natural history, and management of DCIS.

Key Words. Carcinoma-in-situ • Breast • Management