[Intraductal carcinoma of the breast (DCIS). Should the treatment be conservative or not?]

Ann Chir. 1993;47(5):386-91; discussion 391-3.
[Article in French]

Abstract

Due to systematic mammography, DCIS is being seen with increased incidence than in the past. Asymptomatic women screened by mammography show a high incidence of microcalcifications. Lymph node involvement is seen in very few patients. Total mastectomy provides local control and long term survival approaching 100%. Immediate breast reconstruction allows better acceptance of mutilations. Conservative treatment has been advocated for localised DCIS. The classification system dividing DCIS into comedo- and non-comedo subtypes could be an oversimplification because of the frequent histological heterogeneity. Other criteria such as cytological features oncogene activity of C erb 2 and clinical and radiological features must be considered. It has now been demonstrated that DCIS does not have a multicentric distribution. Assessment of lesion size appears to be primordial for breast conservative treatment indications. A relationship has been demonstrated between lesion size and microinvasion. The aim is complete excision with free margins and a cosmetically acceptable postoperative result. Radiotherapy seems to lower the incidence of local recurrences in retrospectives studies. Prospective randomized trials are being conducted to compare lumpectomy with and without radiotherapy.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery*
  • Carcinoma in Situ / diagnostic imaging
  • Carcinoma in Situ / pathology
  • Carcinoma in Situ / radiotherapy
  • Carcinoma in Situ / surgery*
  • Carcinoma, Ductal, Breast / diagnostic imaging
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / radiotherapy
  • Carcinoma, Ductal, Breast / surgery*
  • Combined Modality Therapy
  • Female
  • Humans
  • Lymph Node Excision
  • Mammography / methods
  • Mastectomy, Simple
  • Neoplasm Recurrence, Local