Morrow Monica, O'Sullivan Martin J
Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111-2497, USA.
Breast. 2007 Dec;16 Suppl 2:S59-62. doi: 10.1016/j.breast.2007.07.015. Epub 2007 Aug 21.
The increasingly frequent diagnosis of ductal carcinoma in situ (DCIS) presents a major clinical dilemma. Our inability to predict which DCIS will progress to invasive cancer or the time interval in which recurrent DCIS or invasive cancer will occur has resulted in treatments ranging from mastectomy to excision and observation being offered to patients. Four randomized trials have demonstrated that the use of radiation reduces the risk of local recurrence by about 50% in women with DCIS. Prospective attempts to duplicate retrospective findings that wide excision results in high rates of local control have been unsuccessful. Patient attitudes towards risks and benefits of treatment are an important component of treatment choice in the absence of predictors of biologic behavior.
导管原位癌（DCIS）的诊断日益频繁，这带来了一个重大的临床难题。我们无法预测哪些DCIS会进展为浸润性癌，也无法预测复发性DCIS或浸润性癌会在何时发生，这导致了向患者提供的治疗方案从乳房切除术到切除并观察不等。四项随机试验表明，对于患有DCIS的女性，使用放疗可将局部复发风险降低约50%。前瞻性地试图重复回顾性研究结果（即广泛切除能带来高局部控制率）的尝试并未成功。在缺乏生物学行为预测指标的情况下，患者对治疗风险和益处的态度是治疗选择的一个重要组成部分。
