Bristol Haematology and Oncology Centre, Bristol, UK.
Clin Oncol (R Coll Radiol). 2013 May;25(5):275-82. doi: 10.1016/j.clon.2013.01.007. Epub 2013 Feb 28.
The incidence of ductal carcinoma in situ (DCIS) has increased in recent decades, primarily due to the widespread implementation of breast cancer screening. Traditionally, the management of DCIS has mirrored that of invasive breast cancer, with a focus on adequate surgical excision, breast-conserving surgery, adjuvant radiotherapy and endocrine therapy. However, an increasing understanding of the biology of this spectrum of conditions many mean that some cases may be managed more conservatively, reserving aggressive therapies for those patients at high risk of progression to invasive disease, ultimately aiming for a personalised approach based on individual risk factors. This overview highlights the key evidence behind current practice and discusses the rationale for current and future clinical trials in DCIS.
近年来，导管原位癌（DCIS）的发病率有所增加，主要是由于乳腺癌筛查的广泛实施。传统上，DCIS 的治疗方法与浸润性乳腺癌相似，重点是充分的手术切除、保乳手术、辅助放疗和内分泌治疗。然而，对这一系列疾病生物学的认识不断加深，可能意味着某些情况下可以更保守地治疗，将激进疗法保留给那些有进展为浸润性疾病高风险的患者，最终旨在根据个体风险因素制定个性化的治疗方法。这篇综述强调了当前实践背后的关键证据，并讨论了 DCIS 目前和未来临床试验的原理。
