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• W2913552625 endingPage "915" @default.
• W2913552625 startingPage "896" @default.
• W2913552625 abstract "Ductal carcinoma in situ (DCIS) is a neoplastic proliferation of mammary ductal epithelial cells confined to the ductal-lobular system, and a non-obligate precursor of invasive disease. While there has been a significant increase in the diagnosis of DCIS in recent years due to uptake of mammography screening, there has been little change in the rate of invasive recurrence, indicating that a large proportion of patients diagnosed with DCIS will never develop invasive disease. The main issue for clinicians is how to reliably predict the prognosis of DCIS in order to individualize patient treatment, especially as treatment ranges from surveillance only, breast-conserving surgery only, to breast-conserving surgery plus radiotherapy and/or hormonal therapy, and mastectomy with or without radiotherapy. We conducted a semi-structured literature review to address the above issues relating to pure DCIS. Here we discuss the pathology of DCIS, risk factors for recurrence, biomarkers and molecular signatures, and disease management. Potential mechanisms of progression from DCIS to invasive cancer and problems faced by clinicians and pathologists in diagnosing and treating this disease are also discussed. Despite the tremendous research efforts to identify accurate risk stratification predictors of invasive recurrence and response to radiotherapy and endocrine therapy, to date there is no simple, well-validated marker or group of variables for risk estimation, particularly in the setting of adjuvant treatment after breast-conserving surgery. Thus, the standard of care to date remains breast-conserving surgery plus radiotherapy, with or without hormonal therapy. Emerging tools, such as pathologic or biologic markers, may soon change such practice. Our review also includes recent advances towards innovative treatment strategies, including targeted therapies, immune modulators, and vaccines." @default.
• W2913552625 created "2019-02-21" @default.
• W2913552625 creator A5001373416 @default.
• W2913552625 creator A5007591453 @default.
• W2913552625 creator A5014189905 @default.
• W2913552625 creator A5030395215 @default.
• W2913552625 creator A5054645539 @default.
• W2913552625 creator A5086986429 @default.
• W2913552625 date "2019-07-01" @default.
• W2913552625 modified "2023-10-09" @default.
• W2913552625 title "Ductal carcinoma in situ of the breast: an update for the pathologist in the era of individualized risk assessment and tailored therapies" @default.
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