Current and future treatment of “Ductal Carcinoma in situ” (dcis) of the breast

Ductal carcinoma in situ (DCIS), a non-spreading type of breast cancer, constitutes a major public health problem, and now represents up to half of the cases detected by breast screening. A proportion of these cases detected by routine breast screening would not have progressed to a life-threatening form of breast cancer during the patient’s lifetime, and overdiagnosis of breast cancer is a problem that was recently highlighted during a review of the NHS breast screening programme in the UK. At present, once DCIS has been detected, treatment is obligatory and present technologies do not allow accurate risk stratification such that intensity of treatment can be tailored to risk of recurrence and progression to invasive disease.

 A recent article(1) entitled “Predictors of recurrence for ductal carcinoma in situ after breast conserving surgery” by Prof John R Benson and Professor Gordon C Wishart, both Cambridge-based breast surgeons, has been published in The Lancet Oncology in August 2013 and explains how a combination of traditional and molecular risk factors for DCIS may help to avoid unnecessary treatment in low risk cases and focus maximal therapy on those cases likely to develop into invasive breast cancer.

 1. Benson JR & Wishart GC. Predictors of recurrence for ductal carcinoma in situ following breast conserving surgery. Lancet Oncology August 2013; 14(9): e348-e357