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Invited Commentary
August 2015

No Surgery for Low-Grade Ductal Carcinoma In Situ?

Author Affiliations
  • 1Department of Surgery, Washington University School of Medicine, St Louis, Missouri
  • 2SSM Breast Care, St Charles, Missouri
JAMA Surg. 2015;150(8):746. doi:10.1001/jamasurg.2015.0895

Since the more widespread use of routine screening mammography, the incidence of ductal carcinoma in situ (DCIS) has increased dramatically and accounts for about 20% to 30% of all newly diagnosed breast cancers.1 Deaths from breast cancer among women with DCIS may occur from unidentified invasive disease at the time of diagnosis, progression of inadequately excised DCIS, or the development of an independent recurrent invasive breast cancer.2 Our current inability to accurately predict which women with DCIS are at the greatest risk for developing invasive disease generally necessitates that all patients diagnosed as having DCIS undergo treatment. Despite the relatively benign course of DCIS, most women undergo aggressive surgical and radiation treatment. The risk of overtreatment has been recognized.2

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