Predictive factors for invasive cancer in surgical specimens following an initial diagnosis of ductal carcinoma in situ after stereotactic vacuum-assisted breast biopsy in microcalcification-only lesions

Gümüş, Hatice; Mills, P.; Fish, David E.; Gümüş, Metehan; Cox, Karina; Devalia, Haresh; Jones, Sue; Jones, Peter A.; Sever, Ali

doi:10.5152/dir.2015.14453

Cited by 5 publications

(1 citation statement)

References 26 publications

(47 reference statements)

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“…Inclusion criteria of these studies neglected some important parameters which can predict the presence of invasive carcinoma in initially diagnosed DCIS using core biopsy. Some studies showed that lesion size is an important factor for prediction of invasion in those patients [46][47][48][49].Models designed for DCIS diagnosed with vacuum assessed biopsies (VACB) to predict possibility of presence of invasive disease [50,51]showed that size of the lesion was the main factor in prediction of presence of invasive lesion. Supporting its prognostic value, DCIS size is one of main parameters in the Van Nuys Prognostic Index (VNPI) for prediction of recurrence [52].…”

Section: Critical View To the Current Management Trialsmentioning

confidence: 99%

Current trials to reduce surgical intervention in ductal carcinoma in situ of the breast: Critical review

et al. 2017

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The high proportion of ductal carcinoma in situ (DCIS) presented in mammographic screening and the relatively low risk of progression to invasive disease have raised questions related to overtreatment. Following a review of current DCIS management protocols a more conservative approach has been suggested. Clinical trials have been introduced to evaluate the option of avoiding surgical intervention in a proportion of patients with DCIS defined as "low-risk" using certain clinicopathological criteria. These trials can potentially provide evidence-based models of active surveillance (with or without endocrine therapy) as a future management approach. Despite the undisputable fact of our need to address the obvious overtreatment of screen-detected DCIS, some important questions need to be considered regarding these trials including the eligibility criteria and definition of risk, the proportion of patient eligible for inclusion, and the length of time required for proper analysis of the trials' outcome in view of the long-term natural history of DCIS progression particularly the low-risk group. These factors can potentially affect the practicality and future impact of such trials. This review provides critical analysis of current DCIS management trials and highlights critical issues related to their practicality and the expected outcome.

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