As the use of screening mammography continues to rise, so too does the diagnosis of ductal carcinoma in situ (DCIS), spurring an ongoing debate about how to appropriately manage this condition.
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Traditionally, active treatment similar to that for early-stage breast cancer has been the standard of care, with options ranging from mastectomy to breast conservation surgery (including radiotherapy), with or without subsequent long-term endocrine therapy.
Lately, data from large observational studies have raised the question of whether the current DCIS treatment paradigm is overly aggressive, and whether a more conservative approach employing observation or endocrine therapy alone is justified.
In a review written for JAMA Oncology, Cleveland Clinic Cancer Center radiation oncologist Chirag Shah, MD, and colleagues summarize the current state of data regarding DCIS treatment options and provide perspective on whether conservative strategies are valid in selected low-risk patients.