Should
it be treated as cancer or, in fact, can some of it
be treated by simply excision and observation?
22nd
annual San Antonio Breast Cancer Symposium
(Source: Breast Cancer Update for Surgeons, Program 1 2000)
Play
Audio Below:
Of
course, the randomized trial that addressed this question was the
NSABP’s B-17, through eight years of follow-up. In patients
who underwent excision to a negative margin – simply defined
as tumor cells not touching an inked surface – patients who
were randomized to receive radiotherapy, had a highly significantly
decreased incidence of invasive carcinoma and a significant, although
somewhat lesser decrease, in the incidence of recurrent non-invasive
carcinoma.
Now,
when this study was first reported at year four, when this separation
in curves was noted, it was suggested that this was really due to
the treatment of unrecognized invasive carcinoma and that with further
follow-up, this benefit for radiation would disappear. In fact,
that is not the case. The benefit has persisted and, if anything,
increased with time. So, what everyone would like to know is does
this study tell us that all women with DCIS will benefit from radiation
or can we identify subsets in whom radiation can be eliminated?
Impact
of young age on outcome in patients with ductal carcinoma-in-situ
treated with breast-conserving therapy Vicini, F. A.; Kestin, L. L.; Goldstein, N. S.; Chen, P. Y.;
Pettinga, J.; Frazier, R. C., and Martinez, A. A.. Journal of Clinical
Oncology. 18(2):296-306, 2000 Jan.
Carcinoma
in situ of the breast: correlation of histopathology to immunohistochemical
markers and DNA ploidy. Ottesen,
G. L.; Christensen, I. J.; Larsen, J. K.; Larsen, J.; Baldetorp,
B.; Linden, T.; Hansen, B., and Andersen, J. (Reprint available
from: Ottesen GL Univ Copenhagen, Inst Forens Med, Dept Forens Pathol
Frederik Vs Vej 11,POB 2713 DK-2100 Copenhagen O Denmark).. Breast
Cancer Research & Treatment. 60(3):219-226, 2000 Apr In process
Application
of the Van Nuys prognostic index in a retrospective series of 367
ductal carcinomas in situ of the breast examinated by serial macroscopic
sectioning: Practical considerations. de
Mascarel, I.; Bonichon, F.; MacGrogan, G.; de Lara, C. T.; Avril,
A.; Picot, V.; Durand, M.; Mauriac, L.; Trojani, M., and Coindre,
J. M. Breast Cancer Research & Treatment. 61(2):151-159, 2000
May. In process
Postexcision
mammography is indicated after resection of ductal carcinoma-in-situ
of the breast. Waddell, B. E.; Stomper, P. C.; DeFazio, J. L.; Hurd, T. C.,
and Edge, S. B. Annals of Surgical Oncology. 7(9):665-668, 2000
Oct. In process
Ductal
carcinoma in situ of the breast: A surgeon's disease. Silverstein, M. J. (Reprint available from: Silverstein MJ Univ
So Calif, Kenneth Norris Jr Comprehens Canc Ctr 1441 Eastlake Ave,Room
7415 Los Angeles, CA 90033 USA). Annals of Surgical Oncology. 6(8):802-810,
1999 Dec. No abstract
Role
of specimen radiography in patients treated with skin-sparing mastectomy
for ductal carcinoma in situ of the breast. Rubio, I. T.; Mirza, N.; Sahin, A. A.; Whitman, G.; Kroll, S.
S.; Ames, F. C., and Singletary, S. E. Annals of Surgical Oncology.
7(7):544-548, 2000 Aug. In process
Carcinoma
in situ of the female breast. 10 year follow-up results of a prospective
nationwide study. Ottesen, G. L.; Graversen, H. P.; Blichert-Toft, M.; Christensen,
I. J., and Andersen, J. A. (Reprint available from: Ottesen GL Univ
Copenhagen, Inst Forens Med, Dept Forens Pathol Frederik Vs Vej
11,POB 2713 DK-2100 Copenhagen Denmark).. Breast Cancer Research
& Treatment. 62(3):197-210, 2000 Aug In process
Outcomes
and factors impacting local recurrence of ductal carcinoma in situ. Lagios, M. D. and Silverstein, M. J. (Reprint available from:
Lagios MD St Marys Med Ctr, Breast Canc Consultat Serv San Francisco,
CA 94143 USA).. Cancer. 89(11):2323-2324, 2000 Dec 1. In process
Sentinel
lymph node biopsy: Is it indicated in patients with high-risk ductal
carcinoma-in-situ and ductal carcinoma-in-situ with microinvasion? Klauber-DeMore, N.; Tan, L. K.; Liberman, L.; Kaptain, S.; Fey,
J.; Borgen, P.; Heerdt, A.; Montgomery, L.; Paglia, M.; Petrek,
J. A.; Cody, H. S., and Van Zee, K. J. Annals of Surgical Oncology.
7(9):636-642, 2000 Oct. In process
Relation
of a recurrent intraductal carcinoma (ductal carcinoma in situ)
to the primary tumor Fisher, E. R. and Fisher, B. (Reprint available
from: Fisher B NSABP Sci Directors Off 4 Allegheny Ctr,Suite 602
Pittsburgh, PA 15212 USA).. Journal of the National Cancer Institute.
92(4):288-289, 2000 Feb 16. No abstract
