Ductal carcinoma in situ: to treat or not to treat, that is the question

Maartje van Seijen, Esther H. Lips, Alastair M. Thompson, Serena Nik-Zainal, Andrew Futreal, E. Shelley Hwang, Ellen Verschuur, Joanna Lane, Jos Jonkers, Daniel W. Rea, Jelle Wesseling, on behalf of the PRECISION team

Research output: Contribution to journalReview articleAcademicpeer-review


Ductal carcinoma in situ (DCIS) now represents 20–25% of all ‘breast cancers’ consequent upon detection by population-based breast cancer screening programmes. Currently, all DCIS lesions are treated, and treatment comprises either mastectomy or breast-conserving surgery supplemented with radiotherapy. However, most DCIS lesions remain indolent. Difficulty in discerning harmless lesions from potentially invasive ones can lead to overtreatment of this condition in many patients. To counter overtreatment and to transform clinical practice, a global, comprehensive and multidisciplinary collaboration is required. Here we review the incidence of DCIS, the perception of risk for developing invasive breast cancer, the current treatment options and the known molecular aspects of progression. Further research is needed to gain new insights for improved diagnosis and management of DCIS, and this is integrated in the PRECISION (PREvent ductal Carcinoma In Situ Invasive Overtreatment Now) initiative. This international effort will seek to determine which DCISs require treatment and prevent the consequences of overtreatment on the lives of many women affected by DCIS.
Original languageEnglish
Pages (from-to)285-292
JournalBritish Journal of Cancer
Issue number4
Publication statusPublished - 13 Aug 2019
Externally publishedYes

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