Fujian Medical University Union Hospital, 29 Xinquan Rd, DongJieKou SangQuan, Gulou Qu, Fuzhou Shi, Fujian Sheng 350001, China.
Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA.
Surg Clin North Am. 2018 Aug;98(4):725-745. doi: 10.1016/j.suc.2018.03.007. Epub 2018 May 28.
Ductal carcinoma in situ has been stable in incidence for a decade and has an excellent prognosis. Breast conservation therapy is safe and effective for most patients. Adjuvant whole breast radiation therapy is recommended to reduce the risk of local recurrence. Accelerated partial breast irradiation is a promising alternative to decrease toxicity and improve cosmetic results. Adjuvant hormonal therapy can reduce local recurrence, but should be used cautiously. Future directions in management include developing predictive tools for guidance for use of adjuvant therapy and selecting low-risk patients with ductal carcinoma in situ in whom surgery may be safely omitted.
导管原位癌（DCIS）在过去十年中的发病率一直保持稳定，且预后良好。保乳治疗对大多数患者安全有效。辅助全乳放疗可降低局部复发风险。加速部分乳腺照射是一种有前途的替代方法，可以降低毒性并改善美容效果。辅助激素治疗可以降低局部复发风险，但应谨慎使用。未来的管理方向包括开发预测工具，以指导辅助治疗的应用，并选择低风险的 DCIS 患者，这些患者可安全地免除手术。
