Resolving the Ductal Carcinoma In Situ Treatment Conundrum
Menée sur 327 patientes atteintes d'un carcinome canalaire in situ du sein et traitées par exérèse chirurgicale non combinée à une radiothérapie, cette étude évalue l'association entre le score DCIS, basé sur l'expression de plusieurs gènes associés à des cancers, et le risque de récidive locale
The diagnosis and management of ductal carcinoma in situ (DCIS) is controversial (1). With widespread mammography screening, diagnosis of DCIS became more prevalent. Some are uncertain whether this has translated into a decrease in invasive cancer and a subsequent decline in breast cancer mortality. Part of the concern has been that frequently the treatments of DCIS are as extensive as for invasive cancer with a similar panoply of risks. A straightforward approach to selecting the optimum therapy—defined here as the minimum needed to avoid recurrence, particularly with an invasive component—is needed. Many solutions have been proposed, but none has gained wide acceptance. For example, the Van Nuys Prognostic Index has been in common use for decades (2). Several randomized clinical trials have compared lumpectomy alone to lumpectomy followed by radiation treatment, but no subset analysis of these results has found a group that does not benefit from radiation with a lower in-breast recurrence risk (3)...
Journal of the National Cancer Institute , éditorial en libre accès, 2013