[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-245027-105":53,"doc-detail-245027-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","current-approaches-to-reduce-the-overtreatment-of-dcis","Current Approaches to Reduce the Overtreatment of DCIS","","Routine mammography improves early breast cancer detection but also increases diagnoses of ductal carcinoma in situ (DCIS), a stage 0, non-invasive precursor that often leads to overtreatment. Most patients receive surgery, radiation, and endocrine therapy despite only 20–30% progressing to invasive disease. This overview examines decision-support tools such as Oncotype DX DCIS recurrence score and the evidence base for active surveillance using international phase III trials (LORIS, LORD, LORETTA, COMET).",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":51,"@type":70,"position":76},"https://docshare.wps.com/template/general/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/current-approaches-to-reduce-the-overtreatment-of-dcis/245027/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/current-approaches-to-reduce-the-overtreatment-of-dcis/245027.png","ImageObject",442,249,{"name":88,"@type":89},"Mimi","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-21","2026-09-12",true,{"@type":98,"interactionType":99,"userInteractionCount":73},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Why does DCIS treatment often result in overtreatment?","Question",{"text":108,"@type":109},"Most DCIS is treated like invasive cancer, even though only an estimated 20–30% progress to invasive disease and about 70–80% of women are considered overtreated.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"How can gene expression analysis help manage low-risk DCIS?",{"text":113,"@type":109},"Tools such as the Oncotype DX DCIS recurrence score aim to identify patients who may be able to omit post-lumpectomy radiation therapy, though evidence for routine use across cancer centers remains limited.",{"name":115,"@type":106,"acceptedAnswer":116},"What does active surveillance involve in the COMET trial?",{"text":117,"@type":109},"Participants receive clinical breast exams every six months and mammograms every six months for the affected breast and every 12 months for the unaffected breast, with biopsy triggered by lesion growth or new findings.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},245027,1789224398,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":50,"category_name":51,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":73,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":9},2336477974920,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Current Approaches to Reduce the Overtreatment of DCIS by Victoria Youngblood, Ph. D., M.S. N.-WHNP  \nThe introduction of routine mammography has played a key role in early breast cancer detection and subsequently a reduction in breast cancer-related deaths [1] . However, these advancements in screening have also contributed to ~ 60,000 women each year in the U. S. being diagnosed with ductal carcinoma in situ ( DCIS), a ‘ pre-cancerous lesion’ also referred to as stage 0 breast cancer. This accounts for ~25% of all breast cancer diagnoses. DCIS is diagnosed when the cells that line the milk ducts turn abnormal or malignant but are unable to penetrate through the wall of the duct. As long as these cells remain confi ned to the duct, it is considered non-invasive as they are unable to get into the lymph nodes or blood stream. The goal of therapy for DCIS is to prevent the development of invasive breast cancer. It is estimated that only 20–30% of these pre-cancerous lesions will progress to invasive breast cancer. However, since there is no way to predict whether a case of DCIS will become invasive cancer, it is treated similarly to invasive breast cancer, such that ~97% of women with DCIS undergo a combination of surgery, radiation, and endocrine therapy [2] .  \nRecognizing that approximately 70-80% of women diagnosed with DCIS are being overtreated, oncologists and researchers are earnestly trying to understand why some cases of DCIS develop into invasive breast cancers while others remain stable. Some approaches, including the gene expression analysis tool, Oncotype DX DCIS recurrence score, are used to identify patients that may reasonably omit post-lumpectomy radiation therapy [3] . The data regarding its application remain limited and thus gene expression analyses in DCIS patients are not routine across all cancer centers. Because such prognostic biomarkers are not the standard of care for DCIS, another potential approach to DCIS management is to monitor the lesion carefully and wait—a concept known as active surveillance. This concept of active surveillance is used in other types of low-risk ( pre-) cancers, but is underutilized in DCIS with an estimated 3% of patients choosing this management method. To address this, an international collaboration of active surveillance trials for low-risk DCIS has been initiated.  \nFour prospective phase III clinical trials have launched in the United Kingdom, Europe, Japan, and the United States referred to as LORIS, LORD, LORETTA , and COMET, respectively. Though there are some minor differences across these studies, they similarly only include participants with low-risk, hormone-receptor-positive DCIS. Upon enrollment, participants are randomized to either the control arm in which they undergo the standard of care treatment (surgery +/-radiation and five years of endocrine therapy) or to the experimental arm in which they engage in active surveillance and five years of endocrine therapy if needed (COMET and LORETTA trials only) [4] .  \nActive surveillance, as described by the COMET trial, includes clinical breast examinations every six months, mammogram of the affected breast every six months, and mammogram of the unaffected breast every 12 months. In the event that the original lesion increases in size or if there is a new lesion, a biopsy will be performed. If the new fi ndings are benign or DCIS, active surveillance will resume. If a biopsy reveals invasive ductal carcinoma, the participant will undergo therapy according to standard guidelines [5] .  \nAs screening techniques continue to improve and DCIS diagnoses increase, identifying patients who can safely omit invasive treatments will continue tobe a major focus for researchers. The conclusion of these four clinical trials has the potential to drastically impact future DCIS management in such away that may decrease overtreatment among select patient populations.  \nFor more information about the COMET trial, please visit:  \n[https:/","cbCaie6yErY2SF93","https://ap.wps.com/l/cbCaie6yErY2SF93","pdf",130147,"English","# Current Approaches to Reduce the Overtreatment of DCIS\n## Background and overtreatment problem\n## Risk stratification and prognostic tools\n## Active surveillance and trial design\n## Monitoring protocol and outcomes focus","[{\"question\":\"Why does DCIS treatment often result in overtreatment?\",\"answer\":\"Most DCIS is treated like invasive cancer, even though only an estimated 20–30% progress to invasive disease and about 70–80% of women are considered overtreated.\"},{\"question\":\"How can gene expression analysis help manage low-risk DCIS?\",\"answer\":\"Tools such as the Oncotype DX DCIS recurrence score aim to identify patients who may be able to omit post-lumpectomy radiation therapy, though evidence for routine use across cancer centers remains limited.\"},{\"question\":\"What does active surveillance involve in the COMET trial?\",\"answer\":\"Participants receive clinical breast exams every six months and mammograms every six months for the affected breast and every 12 months for the unaffected breast, with biopsy triggered by lesion growth or new findings.\"}]","Current Approaches to Reduce the Overtreatment of DCIS | PDF"]