Radiation Therapy Following Breast Conserving Surgery for Ductal Carcinoma in situ: Yes or No?

Ductal carcinoma in situ (DCIS) is a non-invasive precursor to breast cancerand represents a heterogenous group of lesions with different malignant potential. Despite several randomized trials, there is still controversy regarding the optimal local treatment for DCIS patients. The addition of radiotherapy after breast conserving surgery approximately halves the local recurrence risk but has no impact on long-term survival. Clinical studies failed to identify a low risk subgroup of DCIS patients treated with breast conserving surgery in whom radiotherapy can be safely omitted. Results of clinical trials of breast conserving surgery radiotherapy are summarized. Treatment decision making in low risk DCIS and current tendencies in the radiotherapy for DCIS are other issues addressed in this paper.