No surgery for low-grade ductal carcinoma in situ?
Menée à partir des données des registres américains des cancers portant sur 57 222 patientes atteintes d'un carcinome canalaire in situ diagnostiqué entre 1988 et 2011 (durée médiane de suivi à partir du diagnostic : 72 mois), cette étude évalue, en fonction de l'agressivité de la lésion cancéreuse, le bénéfice en termes de survie d'un traitement chirurgical
Since the more widespread use of routine screening mammography, the incidence of ductal carcinoma in situ (DCIS) has increased dramatically and accounts for about 20% to 30% of all newly diagnosed breast cancers.1 Deaths from breast cancer among women with DCIS may occur from unidentified invasive disease at the time of diagnosis, progression of inadequately excised DCIS, or the development of an independent recurrent invasive breast cancer.2 Our current inability to accurately predict which women with DCIS are at the greatest risk for developing invasive disease generally necessitates that all patients diagnosed as having DCIS undergo treatment. Despite the relatively benign course of DCIS, most women undergo aggressive surgical and radiation treatment. The risk of overtreatment has been recognized.2
JAMA Surgery , commentaire, 2014