Duktales carcinoma in situ

Ductal carcinoma in situ (DCIS) is a heterogeneous group of lesions, and their classification and treatment is currently the subject of intense discussion. While mastectomy was the standard treatment up to only a few decades ago, as in the case of invasive carcinoma of the breast efforts are now made to save the breast. Studies have documented that adjuvant radiotherapy lowers the risk of a local recurrence of DCIS by 40-60%. Patients with an elevated risk (women under 50 years of age, positive resection margins, high proportion of comedo necroses) in particular benefit from this. It is still not known in which patients it is safe not to perform radiotherapy. Adjuvant tamoxifen also reduces the local recurrence rate. In view of the side effects of tamoxifen, however, the use of this adjuvant therapy should be considered very carefully, especially in the case of patients with comorbidities. Optimal management of therapy for DCIS is impossible without the ascertainment of further prognostic factors. Adequate treatment of DCIS is also of decisive importance from the aspect of preventing invasive carcinoma of the breast.