Ductal Carcinoma In Situ Management: All or Nothing, or Something in between?

AbstractPurpose of ReviewStandard treatment for ductal carcinoma in situ (DCIS) is similar to that of invasive carcinoma. However, there is significant controversy regarding the true clinical implications of DCIS, and thus, the best management strategy. The aim of this review is to highlight relevant biology, diagnostic considerations, treatment options, and recent clinical trials.Recent FindingsOutcomes are generally excellent with low recurrence rates and exceptional disease-specific survival. Outcomes can be predicted using various prognostic indicators and/or nomograms to guide treatment decisions. Ongoing clinical trials of active surveillance are based upon the argument thatipsilateral invasive recurrence is the most clinically meaningful endpoint. These trials seek to compare ipsilateral invasive cancer diagnoses between standard of care and close monitoring.SummaryRecent trials have revealed the marked heterogeneity in the biology of DCIS, offering an opportunity to de-escalate therapy for women at lowest risk for progression. DCIS also presents an ideal setting in which to test novel prevention agents. Future care of patients with DCIS will include biomarker-based risk assessment in order to better individualize treatment to biologic risk of invasive progression.
Source: Current Breast Cancer Reports - Category: Cancer & Oncology Source Type: research

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ConclusionsMRI is the best predictor of tumor size in breast cancer. Histologic type and tumor size are key parameters when estimating tumor size and should be taken into account when planning surgery. Patient age does not interfere with the interpretation of imaging tests.ResumenIntroducciónEl objetivo de este estudio fue evaluar qué prueba de imagen de las empleadas para medir el tamaño del cáncer de mama primario preoperatorio (mamografía, ecografía o resonancia magnética (RM)) se correlacionó mejor con el tamaño del tumor en la pieza quirúrgica posto...
Source: Cirugia Espanola - Category: Surgery Source Type: research
Abstract BACKGROUND: This randomized controlled trial aimed to investigate the effects of circumferential shaving on reducing the intraoperative margin positivity rate (MPR) during breast-conserving surgery (BCS). METHODS: Eligible breast cancer patients were randomly assigned into no-shave and shave groups. In the no-shave group, the cavity margins were collected for assessment after the tumor resection, whereas in the shave group, a circumferential shaving was performed before collecting the cavity margins. The primary outcome was the intraoperative MPR by frozen section analysis. RESULTS: A total of 1...
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research
Breast conserving surgery (BCS) followed by radiation therapy (RT) is the primary management for many women with early-stage, invasive breast cancer and ductal carcinoma in situ (DCIS) [1 –4]. Most women achieve good to excellent cosmesis after BCS and RT but some experience cosmetic failure, defined as fair or poor cosmetic outcomes [5–17]. However, comparisons of cosmetic outcomes across international jurisdictions using contemporary surgical and RT techniques for DCIS are lack ing.
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
Conclusions: The ADC-min values are significantly different among IDC, IDC-DCIS, and DCIS, with the lowest ADC-min values in IDC, followed by IDC-DCIS and DCIS. The ADC-min maybe used as a promising parameter to differentiate DCIS and invasive cancer.
Source: Journal of Cancer Research and Therapeutics - Category: Cancer & Oncology Authors: Source Type: research
In conclusion, the presence of calcifications and vascularity on sonography or a lager distribution of calcifications on mammography may suggest DCISM. PMID: 31396390 [PubMed]
Source: Clinical Breast Cancer - Category: Cancer & Oncology Authors: Tags: Mol Clin Oncol Source Type: research
UCLA researchers have developed an artificial intelligence system that could help pathologists read biopsies more accurately and to better detect and diagnose breast cancer.The new system,described in a study published today in JAMA Network Open, helps interpret medical images used to diagnose breast cancer that can be difficult for the human eye to classify, and it does so nearly as accurately or better as experienced pathologists.“It is critical to get a correct diagnosis from the beginning so that we can guide patients to the most effective treatments,” said Dr. Joann Elmore, the study’s senior author ...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
In 13 –50%, Ductal Carcinoma In Situ (DCIS) progresses to an Invasive Ductal Carcinoma (IDC). As the individual progression risk from DCIS to IDC cannot be estimated based on clinical parameters or biomarkers, all patients with DCIS are medically treated equally. However, the role of tumor microenvironm ent and especially of tumor-associated fibroblasts (TAFs) appears to be critical for progression from DCIS to IDC. Based on previous work by Sameni et al. (2012), the aim of this study was to establish a 3D co-culture of primary fibroblasts and DCIS cells in vitro as a model for further investigatio ns of TAFs’ ...
Source: Maturitas - Category: Primary Care Authors: Tags: LBO03 Source Type: research
ConclusionMetabolic imaging could help to identify the subgroup of indolent lesions from those potentially aggressive ones that may be managed by active surveillance.Key Points• Low- and high-grade DCIS likely arise from two distinct evolutionary paths and when low-grade lesions progress to invasive cancer, the tumor is frequently low grade and well differentiated.• Ongoing clinical trials evaluate whether patients with low-risk DCIS could be safely managed by an active surveillance approach, with avoidance of unnecessary treatments and without impact on ipsilateral invasive breast cancer free survival time.&bull...
Source: European Radiology - Category: Radiology Source Type: research
The objectives of the present study were to obtain the multigene mutation spectra of female breast cancer patients in Northeast China, to explore the correlation between mutations and clinicopathological characteristics, and to identify genetic mutations that correlate with the prognosis and survival of breast cancer patients. An Ion Torrent sequencing platform was used to detect mutations, including 31 known gene mutations associated with breast cancer, in 621 specimens from 286 breast cancer patients. A total of 286 patients were enrolled in this study. Eleven harmful/pathogenic gene mutations were found in 54.2% (155/28...
Source: Oncology Reports - Category: Cancer & Oncology Tags: Oncol Rep Source Type: research
In this study we report the contribution and prognostic significance of GSK3B to two breast cancer subtypes; ductal carcinoma in-situ (DCIS) and invasive ductal carcinoma (IDC) using the Oncomine platform. We performed high throughput screening using molecular docking. We identified BT-000775, a compound that was subjected to further computational hit optimization protocols. Through computational predictions, BT-000775 is a highly selective GSK3B inhibitor, with superior binding affinity and robust ADME profiles suitable for the patho-physiological presentations. PMID: 31354196 [PubMed]
Source: Bioinformation - Category: Bioinformatics Authors: Tags: Bioinformation Source Type: research
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