Should local treatment of breast ductal carcinoma in situ be the same as the treatment of early invasive breast cancer

Abstract

Heterogenicity of breast ductal carcinoma in situ gives rise to opposing proposals concerning its treatment — ranging from attempts to recommend the watch and wait strategy in low risk forms ending with the currently binding stan­dards of treatment of DCIS in the way identical as early invasive cancer in the high risk. Arguments for the treatment of ductal carcinoma in situ in the same way as patients with early invasive cancer have been presented. These argu­ments comprise: unknown natural history of untreated DCIS, high risk of undervaluation of the invasive component in the core-needle biopsy, the increase of recurrence risk with the progress of time, lack of verified separators of the groups with the risk of adverse course of the disease, the results of the clinical studies confirming the justification of combined local treatment and the proof that the clinical course of DCIS is the same as early invasive breast cancer, and, first and foremost, the fact that there are no clinical studies which could justify a limitation of the treatment scope.