Boxer M M, Delaney G P, Chua B H
Liverpool Cancer Therapy Centre, Sydney, Australia.
Breast. 2013 Dec;22(6):1019-25. doi: 10.1016/j.breast.2013.08.012. Epub 2013 Sep 23.
Ductal carcinoma in situ (DCIS) is a heterogeneous, pre-malignant disease accounting for 10-20% of all new breast tumours. Evidence shows a statistically significant local control benefit for adjuvant radiotherapy (RT) following breast conserving surgery (BCS) for all patients. The baseline recurrence risk of individual patients varies according to clinical-pathological criteria and in selected patients, omission of RT may be considered, following a discussion with the patient. The role of adjuvant endocrine therapy remains uncertain. Ongoing studies are attempting to define subgroups of patients who are at sufficiently low risk of recurrence that RT may be safely omitted; investigating RT techniques and dose fractionation schedules; and defining the role of endocrine therapy. Future directions in the management of patients with DCIS will include investigation of prognostic and predictive biomarkers to inform individualised therapy tailored to the risk of recurrence.
导管原位癌（DCIS）是一种异质性的癌前疾病，占所有新发乳腺肿瘤的10%-20%。证据表明，对于所有接受保乳手术（BCS）的患者，辅助放疗（RT）在局部控制方面具有统计学上的显著益处。个体患者的基线复发风险因临床病理标准而异，在某些选定患者中，与患者讨论后可考虑省略放疗。辅助内分泌治疗的作用仍不确定。正在进行的研究试图确定复发风险足够低从而可以安全省略放疗的患者亚组；研究放疗技术和剂量分割方案；以及确定内分泌治疗的作用。DCIS患者管理的未来方向将包括对预后和预测生物标志物的研究，以指导根据复发风险量身定制的个体化治疗。
