[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-372706-105":59,"doc-detail-372706-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","mitigating-overtreatment-of-ductal-carcinoma-in-situ-article","Mitigating overtreatment of ductal carcinoma in situ - Article","","Ductal carcinoma in situ (DCIS) is a breast cancer precursor representing a pathologic continuum from a high-risk lesion to potential invasive cancer. Because breast cancer mortality is linked to metastatic spread, DCIS matters primarily through its risk of future progression and the possibility of an occult invasive cancer missed without surgical excision. Standard care typically involves surgical excision, often with adjuvant therapy, which can overtreat about half of low-risk cases. Personalized management should integrate tumor biology, patient age, comorbidities, and tolerance for risk, using evidence from current and emerging trials.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/mitigating-overtreatment-of-ductal-carcinoma-in-situ-article/372706/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/mitigating-overtreatment-of-ductal-carcinoma-in-situ-article/372706.png","ImageObject",300,407,{"name":92,"@type":93},"Kurz","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is DCIS clinically significant despite being noninvasive?","Question",{"text":113,"@type":114},"DCIS is clinically important because it can progress to invasive cancer over time. It can also coexist with an occult invasive cancer that might be missed without surgical excision.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How can DCIS treatment lead to overtreatment?",{"text":118,"@type":114},"For approximately half of low-risk DCIS cases, standard-of-care management (typically surgical excision with possible adjuvant therapy) may represent overtreatment relative to the actual risk of progression.",{"name":120,"@type":111,"acceptedAnswer":121},"What approach is proposed to minimize overtreatment?",{"text":122,"@type":114},"Treatment should be personalized by considering each patient’s DCIS tumor biology alongside age, medical comorbidities, and tolerance for risk. Ongoing active surveillance trials are expected to help guide safer management.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},372706,1790217185,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":41},2336478945635,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Mitigating overtreatment of ductal carcinoma in situ  \nHannah L. Chung , MD 1,􀀃 , Tanya W. Moseley , MD2,􀀃 , Dulcy E. Wolverton , MD3, Gary J. Whitman , MD4  \n1 Diagnostic Radiology, Breast Imaging Section, Utah Imaging Associates, LLC, Farmington, UT 84025, United States 2 Department of Radiology, University of Mississippi Medical Center, Jackson, MS 39216, United States 3 Department of Radiology, CU Anschutz Medical, Aurora, CO 80045, United States  \n4 Breast Imaging Department, MD Anderson Cancer Center, Houston, TX 77030, United States  \n􀀃 Corresponding author: Hannah L. Chung, MD, Diagnostic Radiology, Breast Imaging Section, Utah Imaging Associates, LLC, 433 North 1075 West, Suite 104, Farmington, UT 84025, United States ([hchung@utahimaging.com](hchung@utahimaging.com)); Department of Radiology, University of Mississippi Medical Center, Jackson, MS 39216, United States ([tmoseley@umc.edu](tmoseley@umc.edu)) .  \nAbstract  \nDuctal carcinoma in situ (DCIS) represents a pathologic continuum between a high-risk lesion of the breast and an invasive cancer. Because death from breast cancer is linked to its metastatic spread, the major significance of DCIS is its potential to progress to an invasive cancer and the risk of an occult invasive cancer unrecognized until surgical excision is performed. The standard of care management for DCIS is a minimum of surgical excision, often coupled with adjuvant treatments. For approximately half of the DCIS cases that are at low risk for progression, standard-of-care treatment represents a potential overtreatment and the source of one of the main criticisms against screening. To minimize overtreatment, the tumor biology of any individual’s DCIS should be considered in the context of the patient’s age, medical comorbidities, and tolerance for risk to tailor personalized treatments. Just as the management of some high-risk lesions of the breast have evolved to include nonsurgical options, it makes sense to personalize the management offered to patients with DCIS. This article reviews the epidemiology, imaging, pathology, ongoing trials, current and possible future treatments of DCIS, comparing and contrasting it with classic high-risk breast lesions and invasive breast cancers. Keywords: ductal carcinoma in situ, active surveillance, high risk lesion of the breast, overdiagnosis, overtreatment  \nAbbreviations  \nADH ¼ atypical ductal hyperplasia; CEM ¼ contrast-enhanced mammography; DCIS ¼ ductal carcinoma in situ; ER ¼ estrogen receptor; HER2 ¼ human epidermal receptor 2; ALH ¼ atypical lobular hyperplasia; LCIS ¼ lobular carcinoma in situ; NCCN ¼ National Comprehensive Cancer Network; RRt ¼ residual risk subtype; SLNB ¼ sentinel lymph node biopsy  \nSummary  \nThe heterogeneity of ductal carcinoma in situ (DCIS) dictates personalized treatment so that low-risk DCIS is not overtreated and high-risk DCIS is treated appropriately to prevent progression to invasive cancer.  \nKey Results  \n􀀏 Breast ductal carcinoma in situ (DCIS) represents a continuum between a high-risk lesion and a nonobligate precursor to invasive cancer.  \n􀀏 While the current standard-of-care treatment for DCIS effectively cures the disease, it may represent overtreatment in a significant portion of cases that are at low risk for progression to an invasive cancer.  \n􀀏 The results of multiple active surveillance clinical trials are expected to help guide future management safely and effectively.  \nIntroduction  \nDuctal carcinoma in situ (DCIS) represents a proliferation of neoplastic cells confined within the basement membrane, without invasion of the myoepithelial layer. Although DCISis considered a form of breast cancer, unlike an invasive cancer, there is not the potential to metastasize beyond the breast and cause harm to the patient’s health and life. The true incidence of DCIS is unknown as approximately 90% of DCIS cases are asymptomatic,1 with the majority of DCIS cases diagnosed at screening mammography, an examinatio","cbCainIiN2Z2ADuI","https://ap.wps.com/l/cbCainIiN2Z2ADuI","pdf",1624477,12,"English","# Abstract\n# Summary\n# Key Results\n# Introduction\n# Pathophysiology of DCIS—what is known and not known","[{\"question\":\"Why is DCIS clinically significant despite being noninvasive?\",\"answer\":\"DCIS is clinically important because it can progress to invasive cancer over time. It can also coexist with an occult invasive cancer that might be missed without surgical excision.\"},{\"question\":\"How can DCIS treatment lead to overtreatment?\",\"answer\":\"For approximately half of low-risk DCIS cases, standard-of-care management (typically surgical excision with possible adjuvant therapy) may represent overtreatment relative to the actual risk of progression.\"},{\"question\":\"What approach is proposed to minimize overtreatment?\",\"answer\":\"Treatment should be personalized by considering each patient’s DCIS tumor biology alongside age, medical comorbidities, and tolerance for risk. Ongoing active surveillance trials are expected to help guide safer management.\"}]","Mitigating overtreatment of ductal carcinoma in situ - Article | PDF",1790195175]