Controversies in the Treatment of Ductal Carcinoma in Situ Academic Article uri icon


MeSH Major

  • Breast Neoplasms
  • Lymph Node Excision
  • Lymphedema
  • Sentinel Lymph Node Biopsy


  • Ductal carcinoma in situ (DCIS) accounts for 20% of all newly diagnosed breast cancers. Mastectomy was once the gold standard for the treatment of DCIS; however, breast-conserving surgery (BCS) has been adopted as the treatment of choice for patients with small, screen-detected lesions. Both adjuvant radiation and hormonal therapy following BCS have been demonstrated in randomized trials to reduce the risk of both invasive and DCIS recurrence, but neither affects survival. With the variety of surgical and adjuvant treatment options available, there has been great interest in tailoring the treatment to the individual, with the goal of optimizing the balance of risks and benefits according to the values and priorities of the woman herself. Prospective studies of women with "low-risk" DCIS treated with BCS alone have successfully identified women at lower than average risk but have not achieved the goal of identifying a subset of women with DCIS at minimal risk of recurrence after surgical excision alone. No studies have evaluated the safety of medical management alone.

publication date

  • January 14, 2017



  • Academic Article



  • eng

PubMed Central ID

  • PMC5532880

Digital Object Identifier (DOI)

  • 10.1146/annurev-med-050715-104920

PubMed ID

  • 28099081

Additional Document Info

start page

  • 197

end page

  • 211


  • 68