Management of DCISA work in progress

Improved screening practices have lead to a dramatic increase in the diagnosis of ductal carcinoma in situ (DCIS) over the past 40 years. At present, it accounts for about 30% of newly diagnosed breast cancers.[1] Our current understanding of the natural history of DCIS indicates that it is an immediate, nonobligate precursor of invasive cancer. DCIS is confined to the breast parenchyma, but if it progresses to invasive breast cancer, the potential exists for the development of distant metastasis and subsequent death. The primary goal of treating DCIS is thus to prevent the development of invasive cancer. Treatment of DCIS is successful for most women; however, the disease can recur, and half of all local recurrences present as invasive breast cancer. At present, we still have a limited understanding of which cases of DCIS will ultimately progress to invasion and which cases will be resistant to therapy. Therefore, tailored management of DCIS is still a work in progress.