Presentation,
22nd annual San Antonio Breast Cancer Symposium
(Source:
Breast Cancer Update for Surgeons, Program 1 2000)
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Audio Below:
What
we begin to see with DCIS, I think, is a picture similar to what
we now have with invasive breast carcinoma; namely, that the intensity
of treatment needs to vary with the level of patients risk,
and that DCIS is a different continuum of diseases with different
levels of risks. And so, it doesnt make any more sense to
assume that all DCIS can be treated with excision alone or that
all DCIS must be treated with excision, irradiation and tamoxifen,
any more than it would make sense to say that all patients with
invasive breast carcinoma must be treated with mastectomy, AC Taxotere
and tamoxifen. Rather, we need to look at risk for an individual
patient. And thats nicely summarized in the B-24 paper in
the Lancet, in which over five years, the risk of failure
in either breast for patients who were treated with excision alone,
is up around the 25 percent mark. For patients treated with excision
and irradiation in both studies, the curves are overlapping, theyre
intermediate. And for patients treated with excision, irradiation
and tamoxifen, we have the lowest failure rates of all, down under
10 percent.
Impact
of young age on outcome in patients with ductal carcinoma-in-situ
treated with breast-conserving therapy Vicini, F. A.; Kestin, L. L.; Goldstein, N. S.; Chen, P. Y.;
Pettinga, J.; Frazier, R. C., and Martinez, A. A.. Journal of Clinical
Oncology. 18(2):296-306, 2000 Jan.
Carcinoma
in situ of the breast: correlation of histopathology to immunohistochemical
markers and DNA ploidy. Ottesen,
G. L.; Christensen, I. J.; Larsen, J. K.; Larsen, J.; Baldetorp,
B.; Linden, T.; Hansen, B., and Andersen, J. (Reprint available
from: Ottesen GL Univ Copenhagen, Inst Forens Med, Dept Forens Pathol
Frederik Vs Vej 11,POB 2713 DK-2100 Copenhagen O Denmark).. Breast
Cancer Research & Treatment. 60(3):219-226, 2000 Apr In process
Application
of the Van Nuys prognostic index in a retrospective series of 367
ductal carcinomas in situ of the breast examinated by serial macroscopic
sectioning: Practical considerations. de
Mascarel, I.; Bonichon, F.; MacGrogan, G.; de Lara, C. T.; Avril,
A.; Picot, V.; Durand, M.; Mauriac, L.; Trojani, M., and Coindre,
J. M. Breast Cancer Research & Treatment. 61(2):151-159, 2000
May. In process
Postexcision
mammography is indicated after resection of ductal carcinoma-in-situ
of the breast. Waddell, B. E.; Stomper, P. C.; DeFazio, J. L.; Hurd, T. C.,
and Edge, S. B. Annals of Surgical Oncology. 7(9):665-668, 2000
Oct. In process
Ductal
carcinoma in situ of the breast: A surgeon's disease. Silverstein, M. J. (Reprint available from: Silverstein MJ Univ
So Calif, Kenneth Norris Jr Comprehens Canc Ctr 1441 Eastlake Ave,Room
7415 Los Angeles, CA 90033 USA). Annals of Surgical Oncology. 6(8):802-810,
1999 Dec. No abstract
Role
of specimen radiography in patients treated with skin-sparing mastectomy
for ductal carcinoma in situ of the breast. Rubio, I. T.; Mirza, N.; Sahin, A. A.; Whitman, G.; Kroll, S.
S.; Ames, F. C., and Singletary, S. E. Annals of Surgical Oncology.
7(7):544-548, 2000 Aug. In process
Carcinoma
in situ of the female breast. 10 year follow-up results of a prospective
nationwide study. Ottesen, G. L.; Graversen, H. P.; Blichert-Toft, M.; Christensen,
I. J., and Andersen, J. A. (Reprint available from: Ottesen GL Univ
Copenhagen, Inst Forens Med, Dept Forens Pathol Frederik Vs Vej
11,POB 2713 DK-2100 Copenhagen Denmark).. Breast Cancer Research
& Treatment. 62(3):197-210, 2000 Aug In process
Outcomes
and factors impacting local recurrence of ductal carcinoma in situ. Lagios, M. D. and Silverstein, M. J. (Reprint available from:
Lagios MD St Marys Med Ctr, Breast Canc Consultat Serv San Francisco,
CA 94143 USA).. Cancer. 89(11):2323-2324, 2000 Dec 1. In process
Sentinel
lymph node biopsy: Is it indicated in patients with high-risk ductal
carcinoma-in-situ and ductal carcinoma-in-situ with microinvasion? Klauber-DeMore, N.; Tan, L. K.; Liberman, L.; Kaptain, S.; Fey,
J.; Borgen, P.; Heerdt, A.; Montgomery, L.; Paglia, M.; Petrek,
J. A.; Cody, H. S., and Van Zee, K. J. Annals of Surgical Oncology.
7(9):636-642, 2000 Oct. In process
Relation
of a recurrent intraductal carcinoma (ductal carcinoma in situ)
to the primary tumor Fisher, E. R. and Fisher, B. (Reprint available
from: Fisher B NSABP Sci Directors Off 4 Allegheny Ctr,Suite 602
Pittsburgh, PA 15212 USA).. Journal of the National Cancer Institute.
92(4):288-289, 2000 Feb 16. No abstract