Stoleru Liviu Sorin, Stoleru Smaranda
Chirurgia (Bucur). 2017 Jul-Aug;112(4):403-412. doi: 10.21614/chirurgia.112.4.403.
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.
导管原位癌（DCIS）是乳腺癌的非侵袭性癌前病变，代表了一组具有不同恶性潜能的异质性病变。尽管进行了多项随机试验，但对于DCIS患者的最佳局部治疗仍存在争议。保乳手术后加用放疗可使局部复发风险降低约一半，但对长期生存无影响。临床研究未能识别出保乳手术后可安全省略放疗的低风险DCIS患者亚组。总结了保乳手术联合放疗的临床试验结果。本文还讨论了低风险DCIS的治疗决策以及DCIS放疗的当前趋势等其他问题。
