Skip to main content
SpringerLink
Log in
Book cover

Ductal Carcinoma In Situ and Microinvasive/Borderline Breast Cancer pp 57–65Cite as

History of Ductal Carcinoma In Situ Management Based Upon Data from Prospective, Randomized Clinical Trials

  • Chapter
  • First Online:

  • 1216 Accesses

Abstract

Screening mammography programs have resulted in dramatic increases in the volume of ductal carcinoma in situ (DCIS) cases diagnosed in the USA over the past 40 years. This has prompted a reevaluation of the historic approach to routine management of DCIS via mastectomy. Prospective, randomized clinical trials have now documented the safety of breast-conserving surgery for DCIS and have also revealed benefits of adjuvant endocrine therapy for these lesions, as most are hormone receptor positive, and the local, antiproliferative activity of these agents suppresses risk of local recurrence in lumpectomy cases. Adjuvant radiation has been widely shown to be beneficial as an adjunct to lumpectomy, but whether radiation and endocrine therapy are interchangeable versus additive in reducing risk of local recurrence remains open to further study. Whether aromatase inhibitors will prove to be of greater benefit than tamoxifen is a subject of ongoing clinical trials.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Ernster VL, Barclay J, Kerlikowske K, Grady D, Henderson C. Incidence of and treatment for ductal carcinoma in situ of the breast. JAMA. 1996;275:913–8.

    Article  CAS  PubMed  Google Scholar 

  2. Zujewski JA, Harlan LC, Morrell DM, Stevens JL. Ductal carcinoma in situ: trends in treatment over time in the US. Breast Cancer Res Treat. 2011;127:251–7.

    Article  PubMed  Google Scholar 

  3. Khan A, Newman LA. Diagnosis and management of ductal carcinoma in situ. Curr Treat Options Oncol. 2004;5:131–44.

    Article  PubMed  Google Scholar 

  4. Bleyer A, Welch HG. Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med. 2012;367:1998–2005.

    Article  CAS  PubMed  Google Scholar 

  5. Bleyer A, Welch HG. Effect of screening mammography on breast cancer incidence. N Engl J Med. 2013;368:679.

    CAS  PubMed  Google Scholar 

  6. Nielsen M, Jensen J, Andersen J. Precancerous and cancerous breast lesions during lifetime and at autopsy. A study of 83 women. Cancer. 1984;54:612–5.

    Article  CAS  PubMed  Google Scholar 

  7. Nielsen M, Thomsen JL, Primdahl S, Dyreborg U, Andersen JA. Breast cancer and atypia among young and middle-aged women: a study of 110 medicolegal autopsies. Br J Cancer. 1987;56:814–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Alpers CE, Wellings SR. The prevalence of carcinoma in situ in normal and cancer-associated breasts. Hum Pathol. 1985;16:796–807.

    Article  CAS  PubMed  Google Scholar 

  9. Bhathal PS, Brown RW, Lesueur GC, Russell IS. Frequency of benign and malignant breast lesions in 207 consecutive autopsies in Australian women. Br J Cancer. 1985;51:271–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Rosen PP, Braun DW Jr., Kinne DE. The clinical significance of pre-invasive breast carcinoma. Cancer. 1980;46:919–25.

    Article  CAS  PubMed  Google Scholar 

  11. Betsill WL Jr., Rosen PP, Lieberman PH, Robbins GF. Intraductal carcinoma. Long-term follow-up after treatment by biopsy alone. JAMA. 1978;239:1863–7.

    Article  PubMed  Google Scholar 

  12. Page DL, Dupont WD, Rogers LW, Landenberger M. Intraductal carcinoma of the breast: follow-up after biopsy only. Cancer. 1982;49:751–8.

    Article  CAS  PubMed  Google Scholar 

  13. Page DL, Dupont WD, Rogers LW, Jensen RA, Schuyler PA. Continued local recurrence of carcinoma 15–25 years after a diagnosis of low grade ductal carcinoma in situ of the breast treated only by biopsy. Cancer. 1995;76:1197–200.

    Article  CAS  PubMed  Google Scholar 

  14. Sanders ME, Schuyler PA, Dupont WD, Page DL. The natural history of low-grade ductal carcinoma in situ of the breast in women treated by biopsy only revealed over 30 years of long-term follow-up. Cancer. 2005;103:2481–4.

    Article  PubMed  Google Scholar 

  15. Allred D, Bryant J, Land S, et al. Estrogen receptor expression as a predictive marker of the effectiveness of tamoxifen in the treatment of DCIS: findings from NSABP Protocol B-24. 25th Annual San Antonio Breast Cancer Symposium, Abstract No 30. San Antonio, Texas; 2002.

    Google Scholar 

  16. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.

    Article  PubMed  Google Scholar 

  17. Fisher ER, Leeming R, Anderson S, Redmond C, Fisher B. Conservative management of intraductal carcinoma (DCIS) of the breast. Collaborating NSABP investigators. J Surg Oncol. 1991;47:139–47.

    Article  CAS  PubMed  Google Scholar 

  18. Newman LA. Local control of ductal carcinoma in situ based on tumor and patient characteristics: the surgeon’s perspective. J Natl Cancer Inst Monogr. 2010;2010:152–7.

    Article  PubMed  Google Scholar 

  19. Julien JP, Bijker N, Fentiman IS, et al. Radiotherapy in breast-conserving treatment for ductal carcinoma in situ: first results of the EORTC randomised phase III trial 10853. EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. Lancet. 2000;355:528–33.

    Article  CAS  PubMed  Google Scholar 

  20. Bijker N, Meijnen P, Peterse JL, et al. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: 10-year results of european organisation for research and treatment of cancer randomized phase III trial 10853–a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. J Clin Oncol. 2006;24:3381–7.

    Article  PubMed  Google Scholar 

  21. Bijker N, Peterse JL, Duchateau L, et al. Risk factors for recurrence and metastasis after breast-conserving therapy for ductal carcinoma-in-situ: analysis of European Organization for Research and Treatment of Cancer Trial 10853. J Clin Oncol. 2001;19:2263–71.

    CAS  PubMed  Google Scholar 

  22. Fisher B, Dignam J, Wolmark N, et al. Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17. J Clin Oncol. 1998;16:441–52.

    CAS  PubMed  Google Scholar 

  23. Fisher ER, Dignam J, Tan-Chiu E, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) eight-year update of Protocol B-17: intraductal carcinoma. Cancer. 1999;86:429–38.

    Article  CAS  PubMed  Google Scholar 

  24. Fisher B, Dignam J, Wolmark N, et al. Tamoxifen in treatment of intraductal breast cancer: National Surgical Adjuvant Breast and Bowel Project B-24 randomised controlled trial. Lancet. 1999;353:1993–2000.

    Article  CAS  PubMed  Google Scholar 

  25. Houghton J, George WD, Cuzick J, Duggan C, Fentiman IS, Spittle M. Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK, Australia, and New Zealand: randomised controlled trial. Lancet. 2003;362:95–102.

    Article  PubMed  Google Scholar 

  26. Fisher ER, Costantino J, Fisher B, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) Protocol B-17. Five-year observations concerning lobular carcinoma in situ. Cancer. 1996;78:1403–16.

    Article  CAS  PubMed  Google Scholar 

  27. Fisher ER, Costantino J, Fisher B, Palekar AS, Redmond C, Mamounas E. Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) Protocol B-17. Intraductal carcinoma (ductal carcinoma in situ). The National Surgical Adjuvant Breast and Bowel Project Collaborating Investigators. Cancer. 1995;75:1310–9.

    Article  CAS  PubMed  Google Scholar 

  28. Fisher B, Land S, Mamounas E, Dignam J, Fisher ER, Wolmark N. Prevention of invasive breast cancer in women with ductal carcinoma in situ: an update of the National Surgical Adjuvant Breast and Bowel Project experience. Semin Oncol. 2001;28:400–18.

    Article  CAS  PubMed  Google Scholar 

  29. Fisher ER, L, and SR, Saad RS, et al. Pathologic variables predictive of breast events in patients with ductal carcinoma in situ. Am J Clin Pathol. 2007;128:86–91.

    Article  PubMed  Google Scholar 

  30. Wapnir IL, Dignam JJ, Fisher B, et al. Long-term outcomes of invasive ipsilateral breast tumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS. J Natl Cancer Inst. 2011;103:478–88.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Allred DC, Anderson SJ, Paik S, et al. Adjuvant tamoxifen reduces subsequent breast cancer in women with estrogen receptor-positive ductal carcinoma in situ: a study based on NSABP protocol B-24. J Clin Oncol. 2012;30:1268–73.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Cuzick J. IBIS II: a breast cancer prevention trial in postmenopausal women using the aromatase inhibitor anastrozole. Expert Rev Anticancer Ther. 2008;8:1377–85.

    Article  CAS  PubMed  Google Scholar 

  33. Cuzick J, Sestak I, Forbes JF, et al. Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial. Lancet. 2014;383:1041–8.

    Article  CAS  PubMed  Google Scholar 

  34. Juraskova I, Butow P, Bonner C, et al. Improving decision making about clinical trial participation—a randomised controlled trial of a decision aid for women considering participation in the IBIS-II breast cancer prevention trial. Br J Cancer. 2014;111:1–7.

    Article  CAS  PubMed  Google Scholar 

  35. Dixon JM, Jane Macaskill E. Endocrine therapy in DCIS: how do we proceed? Breast J. 2012;18:295–8.

    Article  PubMed  Google Scholar 

  36. Cuzick J, Forbes JF, Sestak I, et al. Long-term results of tamoxifen prophylaxis for breast cancer–96-month follow-up of the randomized IBIS-I trial. J Natl Cancer Inst. 2007;99:272–82.

    Article  CAS  PubMed  Google Scholar 

  37. Fisher B, Costantino J, Wickerham D, Cecchini R, Cronin W, Robidoux A. Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Natl Cancer Inst. 2005;97:1652–62.

    Article  CAS  PubMed  Google Scholar 

  38. Vogel VG, Costantino JP, Wickerham DL, et al. Update of the National Surgical Adjuvant Breast and Bowel Project Study of tamoxifen and raloxifene (STAR) P-2 trial: preventing breast cancer. Cancer Prev Res (Phila). 2010;3:696–706.

    Article  CAS  Google Scholar 

  39. Dixon JM, Faratian D, White S, et al. DCIS and aromatase inhibitors. J Steroid Biochem Mol Biol. 2007;106:173–9.

    Article  CAS  PubMed  Google Scholar 

  40. Chlebowski R. Lifestyle change including dietary fat reduction and breast cancer outcome. J Nutr. 2007;137:233S–5S.

    CAS  PubMed  Google Scholar 

  41. Yen TW, Hunt KK, Mirza NQ, et al. Physician recommendations regarding tamoxifen and patient utilization of tamoxifen after surgery for ductal carcinoma in situ. Cancer. 2004;100:942–9.

    Article  CAS  PubMed  Google Scholar 

  42. Hird RB, Chang A, Cimmino V, et al. Impact of estrogen receptor expression and other clinicopathologic features on tamoxifen use in ductal carcinoma in situ. Cancer. 2006;106:2113–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Comprehensive Cancer Center, University of Michigan Health System, 1500 East Medical Center Drive, 48167, Ann Arbor, MI, USA

    Lisa A. Newman MD, MPH, FACS & Jessica M. Bensenhaver MD

Authors
  1. Lisa A. Newman MD, MPH, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jessica M. Bensenhaver MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisa A. Newman MD, MPH, FACS .

Editor information

Editors and Affiliations

  1. Comprehensive Cancer Center, University of Michigan Health System, Ann Arbor, Michigan, USA

    Lisa A. Newman

  2. Comprehensive Cancer Center, University of Michigan Health System, Ann Arbor, Michigan, USA

    Jessica M. Bensenhaver

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Newman, L., Bensenhaver, J. (2015). History of Ductal Carcinoma In Situ Management Based Upon Data from Prospective, Randomized Clinical Trials. In: Newman, L., Bensenhaver, J. (eds) Ductal Carcinoma In Situ and Microinvasive/Borderline Breast Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2035-8_6

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-2035-8_6

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2034-1

  • Online ISBN: 978-1-4939-2035-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation