Posner M C, Wolmark N
University of Pittsburgh, School of Medicine.
Breast Cancer Res Treat. 1992;21(3):155-64. doi: 10.1007/BF01974998.
Non-invasive breast cancer is comprised of two distinct entities: lobular carcinoma in-situ (LCIS) and ductal carcinoma in-situ (DCIS). The natural history of each clinical entity is described and a biologic interpretation of the available data is offered. Lobular carcinoma in-situ is considered only a risk marker rather than a precursor for the subsequent development of invasive cancer, so that once the diagnosis is established, further operative intervention is unnecessary and serial follow-up alone is recommended. The treatment of ductal carcinoma in-situ must take into account that breast-preserving therapy is now considered optimal treatment of invasive cancer of the breast, the disease we are trying to prevent. The pitfalls of recommending treatment based on retrospective data is emphasized and the need to support clinical trials designed to determine the optimal therapeutic management of intraductal carcinoma is affirmed.
小叶原位癌（LCIS）和导管原位癌（DCIS）。本文描述了每个临床实体的自然病史，并对现有数据进行了生物学解释。小叶原位癌仅被视为一种风险标志物，而非浸润性癌后续发展的前驱病变，因此一旦确诊，无需进一步手术干预，仅建议进行系列随访。导管原位癌的治疗必须考虑到，保乳治疗目前被认为是乳腺癌（我们试图预防的疾病）浸润性癌的最佳治疗方法。强调了基于回顾性数据推荐治疗的缺陷，并肯定了支持旨在确定导管内癌最佳治疗管理的临床试验的必要性。
