Kerlikowske Karla
General Internal Medicine Section, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, 4150 Clement St, 111A1, San Francisco, CA 94121, USA.
J Natl Cancer Inst Monogr. 2010;2010(41):139-41. doi: 10.1093/jncimonographs/lgq027.
Ductal carcinoma in situ (DCIS) is a relatively common diagnosis among women undergoing screening mammography. The greatest increases in DCIS incidence have been in non-comedo subtypes of DCIS that are not associated with subsequent invasive cancer. After a 500% increase in DCIS from 1983 to 2003, the incidence of DCIS declined in women aged 50 years and older, whereas the incidence in women younger than age 50 continues to increase. Having undergone mammography is one of the strongest and most prevalent risk factors associated with a diagnosis of DCIS. Other risk factors for DCIS are similar to that for invasive cancer including increasing age, family history of breast cancer, high mammographic breast density, and postmenopausal hormone therapy use. Treatment for DCIS is relatively aggressive with the use of both surgery and radiation therapy and most recently adjuvant hormonal therapy. Breast cancer mortality is low and similar with all types of treatment. New information regarding incidence of DCIS and subtypes of DCIS according to frequency of mammography and risk factors could lead to insights into the biology of DCIS.
导管原位癌（DCIS）在接受乳腺钼靶筛查的女性中是一种相对常见的诊断。DCIS发病率增长最大的是与后续浸润性癌无关的非粉刺型DCIS亚型。从1983年到2003年DCIS发病率增长了500%之后，50岁及以上女性的DCIS发病率下降，而50岁以下女性的发病率持续上升。接受过乳腺钼靶检查是与DCIS诊断相关的最强且最普遍的风险因素之一。DCIS的其他风险因素与浸润性癌相似，包括年龄增长、乳腺癌家族史、乳腺钼靶显示的乳腺密度高以及绝经后激素治疗的使用。DCIS的治疗相对积极，采用手术和放射治疗，最近还采用辅助激素治疗。乳腺癌死亡率较低，且各种治疗方式的死亡率相似。关于DCIS发病率以及根据乳腺钼靶检查频率和风险因素划分的DCIS亚型的新信息可能会带来对DCIS生物学特性的深入了解。
