Ductal Carcinoma in Situ: Through a Glass, Darkly

Excerpt

Today, ductal carcinoma in situ (DCIS) remains a growing clinical problem and a therapeutic conundrum, reflected by enormous volume of often contradictory literature devoted particularly to the mammographically detected form of this disease. Over the last 25 years, certain common findings have emerged from multiple independent studies that allow us to stratify the risk of a subsequent event related to the treatment of DCIS. Critical to our understanding of local control of DCIS is the ability to establish the margin status, size, and grade of an individual patient’s lesion and the availability of a thorough pathology protocol to permit reproducible evaluation and comparison between studies. One should be able to compare these pathological predictive factors, independently of specific treatments, and have an adequate follow-up for a disease that may not exhibit any recurrence in the initial 7–10 years. Two manuscripts published in this issue of the journal illustrate some of the common findings and some of the problems in interpreting this literature. …