From the Guidelines
Cancer in situ should be treated with surgical excision, and radiation therapy should be considered after breast-conserving surgery to reduce the recurrence risk, as recommended by the most recent guidelines 1. The goal of treatment for cancer in situ is to prevent the development of invasive cancer, and the approach to treatment has evolved over time.
- Historically, mastectomy was the primary treatment for ductal carcinoma in situ (DCIS) 1.
- However, with the advent of screening mammography, DCIS is now often detected at an early stage, and breast-conserving surgery has become a viable option for many women 1.
- The decision to use radiation therapy after breast-conserving surgery should be based on the individual patient's risk factors, such as the size of the tumor, the presence of comedonecrosis, and the margin status 1.
- The use of adjuvant endocrine therapy, such as tamoxifen or an aromatase inhibitor, may also be considered to reduce the risk of recurrence and prevent contralateral disease 1.
- It is essential to note that the management of DCIS should be individualized, taking into account the patient's age, overall health, and personal preferences 1.
- Regular follow-up examinations are crucial after treatment to monitor for any signs of recurrence or the development of new cancers 1.
- The prognosis for cancer in situ is generally excellent, with high cure rates approaching 100% when properly treated, as the cancer has not yet gained the ability to metastasize 1.
From the Research
Definition and Treatment of Cancer in Situ
- Cancer in situ refers to a condition where cancerous cells are present but have not spread to other parts of the body 2, 3, 4.
- Ductal carcinoma in situ (DCIS) is a type of cancer in situ that occurs in the breast and is considered a precursor to invasive breast cancer 2, 3, 4.
- Treatment options for DCIS include mastectomy, breast-conserving surgery, and radiation therapy, with the goal of preventing the development of invasive breast cancer 2, 3, 4.
Diagnosis and Accuracy of Core Biopsy
- Core biopsy is a diagnostic method used to confirm the presence of cancer in situ, including DCIS 5.
- The accuracy of core biopsy in diagnosing DCIS is lower compared to invasive breast cancer, with smaller lesion size and lower grade associated with increased risk of a negative or non-diagnostic core biopsy 5.
- Preoperative diagnosis of DCIS by core biopsy can reduce the number of surgical procedures, making it a valuable tool in the management of DCIS 5.
Comparison of Treatment Methods
- Different treatment methods, such as cold knife cone biopsy and loop electrosurgical excision procedure, have been compared in the management of cervical adenocarcinoma in situ (ACIS) 6.
- The study found that both methods appear equally effective in treating ACIS, with patients undergoing conservative management requiring close monitoring, particularly if biopsy margins are positive 6.