Don’t prescribe neither chemotherapy nor radiotherapy in the treatment of ductal carcinoma in situ of the breast.
The widespread screening for early detection of breast cancer has led to the frequent identification of early forms of cancer, especially carcinoma in situ: lobular carcinoma in situ and, more frequently, ductal carcinoma in situ (DCIS). Since these types of cancer may evolve towards infiltrating forms, the local and the systemic treatment are performed to prevent the invasive cancer or the cancer in the contralateral breast.DCIS can be treated with conservative surgery or with simple mastectomy. There is no scientific evidence in support of chemotherapy or radiotherapy in the treatment of DCIS, although this therapeutic approach was fairly common until recent years. Conversely, randomized phase III trials support the use of tamoxifen after local surgical treatment.
Sources
1. http://www.nccn.org/patients/guidelines/breast/files/assets/basic-html/page62.html
2. Linee Guida dell’Oncologia Italiana AIOM 2012 pag 22-25, edizioni AIOM Milano.
3. De Mascarel I.,et al. Breast ductal carcinoma in situ with microinvasion: a definition supported by a long-term study of 1248 serially sectioned ductal carcinomas. Cancer 2002; 94: 2134-2142.
4. Adamovich TL, et al. Ductal carcinoma in situ with microinvasion. Am J Surg 2003; 186:112-116.
5. Esserman L.J. et al., Overdiagnosis and overtreatment in Cancer, JAMA july 29, 2013 http://jama.jamanetwork.com on 07/29/2013.
6. Narod SA, Iqbal J, Giannakeas V, Sopik V, Sun P. Breast Cancer Mortality After a Diagnosis of Ductal Carcinoma In Situ. JAMA Oncol. 2015 Oct;1(7):888-96. doi: 10.1001/jamaoncol.2015.2510.
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.
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