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Breast Ductal Carcinoma In Situ, Low Grade

MedGen UID:
233617
•Concept ID:
C1334413
•
Neoplastic Process
Synonyms: DCIS Grade 1; Ductal Intraepithelial Neoplasia, Grade 1C; Low Grade Ductal Breast Carcinoma In Situ; Low-Grade DCIS; Low-Grade Ductal Carcinoma In Situ of Breast

Definition

Breast ductal carcinoma in situ characterized by the presence of small, monomorphic neoplastic cells that form cribriform, micropapillary, or solid patterns. The nuclei are uniform and mitotic figures are rare. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVBreast Ductal Carcinoma In Situ, Low Grade

Professional guidelines

PubMed

DCIS: Risk Assessment in the Molecular Era.
Knowlton CA, Jimenez RB, Moran MS
Semin Radiat Oncol 2022 Jul;32(3):189-197. doi: 10.1016/j.semradonc.2022.01.005. PMID: 35688517
The Clinical Utility of DCISionRT(®) on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery.
Shah C, Bremer T, Cox C, Whitworth P, Patel R, Patel A, Brown E, Gold L, Rock D, Riley L, Kesslering C, Brown S, Gabordi R, Pellicane J, Rabinovich R, Khan S, Templeton S, Majithia L, Willey SC, Wärnberg F, Gerber NK, Shivers S, Vicini FA
Ann Surg Oncol 2021 Oct;28(11):5974-5984. Epub 2021 Apr 5 doi: 10.1245/s10434-021-09903-1. PMID: 33821346Free PMC Article
Management of ductal carcinoma in situ in the modern era.
Khan A, Dumitru D, Catanuto G, Rocco N, Nava MB, Benson J
Minerva Chir 2018 Jun;73(3):303-313. Epub 2018 Mar 28 doi: 10.23736/S0026-4733.18.07729-5. PMID: 29589680

Recent clinical studies

Etiology

Radiation doses and fractionation schedules in non-low-risk ductal carcinoma in situ in the breast (BIG 3-07/TROG 07.01): a randomised, factorial, multicentre, open-label, phase 3 study.
Chua BH, Link EK, Kunkler IH, Whelan TJ, Westenberg AH, Gruber G, Bryant G, Ahern V, Purohit K, Graham PH, Akra M, McArdle O, O'Brien P, Harvey JA, Kirkove C, Maduro JH, Campbell ID, Delaney GP, Martin JD, Vu TTT, Muanza TM, Neal A, Olivotto IA; BIG 3–07/TROG 07.01 trial investigators
Lancet 2022 Aug 6;400(10350):431-440. doi: 10.1016/S0140-6736(22)01246-6. PMID: 35934006
Randomized Phase III Trial Evaluating Radiation Following Surgical Excision for Good-Risk Ductal Carcinoma In Situ: Long-Term Report From NRG Oncology/RTOG 9804.
McCormick B, Winter KA, Woodward W, Kuerer HM, Sneige N, Rakovitch E, Smith BL, Germain I, Hartford AC, O'Rourke MA, Walker EM, Strom EA, Hopkins JO, Pierce LJ, Pu AT, Sumida KNM, Vesprini D, Moughan J, White JR
J Clin Oncol 2021 Nov 10;39(32):3574-3582. Epub 2021 Aug 18 doi: 10.1200/JCO.21.01083. PMID: 34406870Free PMC Article
The Clinical Utility of DCISionRT(®) on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery.
Shah C, Bremer T, Cox C, Whitworth P, Patel R, Patel A, Brown E, Gold L, Rock D, Riley L, Kesslering C, Brown S, Gabordi R, Pellicane J, Rabinovich R, Khan S, Templeton S, Majithia L, Willey SC, Wärnberg F, Gerber NK, Shivers S, Vicini FA
Ann Surg Oncol 2021 Oct;28(11):5974-5984. Epub 2021 Apr 5 doi: 10.1245/s10434-021-09903-1. PMID: 33821346Free PMC Article
Hypofractionated Versus Standard Fractionated Radiotherapy in Patients With Early Breast Cancer or Ductal Carcinoma In Situ in a Randomized Phase III Trial: The DBCG HYPO Trial.
Offersen BV, Alsner J, Nielsen HM, Jakobsen EH, Nielsen MH, Krause M, Stenbygaard L, Mjaaland I, Schreiber A, Kasti UM, Overgaard J; Danish Breast Cancer Group Radiation Therapy Committee
J Clin Oncol 2020 Nov 1;38(31):3615-3625. Epub 2020 Sep 10 doi: 10.1200/JCO.20.01363. PMID: 32910709
Surgical Excision Without Radiation for Ductal Carcinoma in Situ of the Breast: 12-Year Results From the ECOG-ACRIN E5194 Study.
Solin LJ, Gray R, Hughes LL, Wood WC, Lowen MA, Badve SS, Baehner FL, Ingle JN, Perez EA, Recht A, Sparano JA, Davidson NE
J Clin Oncol 2015 Nov 20;33(33):3938-44. Epub 2015 Sep 14 doi: 10.1200/JCO.2015.60.8588. PMID: 26371148Free PMC Article

Diagnosis

Radiation doses and fractionation schedules in non-low-risk ductal carcinoma in situ in the breast (BIG 3-07/TROG 07.01): a randomised, factorial, multicentre, open-label, phase 3 study.
Chua BH, Link EK, Kunkler IH, Whelan TJ, Westenberg AH, Gruber G, Bryant G, Ahern V, Purohit K, Graham PH, Akra M, McArdle O, O'Brien P, Harvey JA, Kirkove C, Maduro JH, Campbell ID, Delaney GP, Martin JD, Vu TTT, Muanza TM, Neal A, Olivotto IA; BIG 3–07/TROG 07.01 trial investigators
Lancet 2022 Aug 6;400(10350):431-440. doi: 10.1016/S0140-6736(22)01246-6. PMID: 35934006
Ductal Carcinoma In Situ - Quo Vadis?
Peltecu G
Chirurgia (Bucur) 2021 Dec;116(5 Suppl):S5-S6. PMID: 34967322
Low-Grade Ductal Carcinoma In Situ.
Alghamdi SA, Krishnamurthy K, Garces Narvaez SA, Algashaamy KJ, Aoun J, Reis IM, Recine MA, Jorda M, Poppiti RJ, Gomez-Fernandez CR
Am J Clin Pathol 2020 Feb 8;153(3):360-367. doi: 10.1093/ajcp/aqz179. PMID: 31769792
Behaviour and characteristics of low-grade ductal carcinoma in situ of the breast: literature review and single-centre retrospective series.
Koh VCY, Lim JCT, Thike AA, Cheok PY, Thu MMM, Li H, Tan VKM, Ong KW, Tan BKT, Ho GH, Thilagaratnam S, Wong JSL, Wong FY, Ellis IO, Tan PH
Histopathology 2019 Jun;74(7):970-987. Epub 2019 Mar 28 doi: 10.1111/his.13837. PMID: 30734334
RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation.
McCormick B, Winter K, Hudis C, Kuerer HM, Rakovitch E, Smith BL, Sneige N, Moughan J, Shah A, Germain I, Hartford AC, Rashtian A, Walker EM, Yuen A, Strom EA, Wilcox JL, Vallow LA, Small W Jr, Pu AT, Kerlin K, White J
J Clin Oncol 2015 Mar 1;33(7):709-15. Epub 2015 Jan 20 doi: 10.1200/JCO.2014.57.9029. PMID: 25605856Free PMC Article

Therapy

Radiation doses and fractionation schedules in non-low-risk ductal carcinoma in situ in the breast (BIG 3-07/TROG 07.01): a randomised, factorial, multicentre, open-label, phase 3 study.
Chua BH, Link EK, Kunkler IH, Whelan TJ, Westenberg AH, Gruber G, Bryant G, Ahern V, Purohit K, Graham PH, Akra M, McArdle O, O'Brien P, Harvey JA, Kirkove C, Maduro JH, Campbell ID, Delaney GP, Martin JD, Vu TTT, Muanza TM, Neal A, Olivotto IA; BIG 3–07/TROG 07.01 trial investigators
Lancet 2022 Aug 6;400(10350):431-440. doi: 10.1016/S0140-6736(22)01246-6. PMID: 35934006
Randomized Phase III Trial Evaluating Radiation Following Surgical Excision for Good-Risk Ductal Carcinoma In Situ: Long-Term Report From NRG Oncology/RTOG 9804.
McCormick B, Winter KA, Woodward W, Kuerer HM, Sneige N, Rakovitch E, Smith BL, Germain I, Hartford AC, O'Rourke MA, Walker EM, Strom EA, Hopkins JO, Pierce LJ, Pu AT, Sumida KNM, Vesprini D, Moughan J, White JR
J Clin Oncol 2021 Nov 10;39(32):3574-3582. Epub 2021 Aug 18 doi: 10.1200/JCO.21.01083. PMID: 34406870Free PMC Article
Hypofractionated Versus Standard Fractionated Radiotherapy in Patients With Early Breast Cancer or Ductal Carcinoma In Situ in a Randomized Phase III Trial: The DBCG HYPO Trial.
Offersen BV, Alsner J, Nielsen HM, Jakobsen EH, Nielsen MH, Krause M, Stenbygaard L, Mjaaland I, Schreiber A, Kasti UM, Overgaard J; Danish Breast Cancer Group Radiation Therapy Committee
J Clin Oncol 2020 Nov 1;38(31):3615-3625. Epub 2020 Sep 10 doi: 10.1200/JCO.20.01363. PMID: 32910709
Surgical Excision Without Radiation for Ductal Carcinoma in Situ of the Breast: 12-Year Results From the ECOG-ACRIN E5194 Study.
Solin LJ, Gray R, Hughes LL, Wood WC, Lowen MA, Badve SS, Baehner FL, Ingle JN, Perez EA, Recht A, Sparano JA, Davidson NE
J Clin Oncol 2015 Nov 20;33(33):3938-44. Epub 2015 Sep 14 doi: 10.1200/JCO.2015.60.8588. PMID: 26371148Free PMC Article
RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation.
McCormick B, Winter K, Hudis C, Kuerer HM, Rakovitch E, Smith BL, Sneige N, Moughan J, Shah A, Germain I, Hartford AC, Rashtian A, Walker EM, Yuen A, Strom EA, Wilcox JL, Vallow LA, Small W Jr, Pu AT, Kerlin K, White J
J Clin Oncol 2015 Mar 1;33(7):709-15. Epub 2015 Jan 20 doi: 10.1200/JCO.2014.57.9029. PMID: 25605856Free PMC Article

Prognosis

Ductal Carcinoma In Situ - Quo Vadis?
Peltecu G
Chirurgia (Bucur) 2021 Dec;116(5 Suppl):S5-S6. PMID: 34967322
The Clinical Utility of DCISionRT(®) on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery.
Shah C, Bremer T, Cox C, Whitworth P, Patel R, Patel A, Brown E, Gold L, Rock D, Riley L, Kesslering C, Brown S, Gabordi R, Pellicane J, Rabinovich R, Khan S, Templeton S, Majithia L, Willey SC, Wärnberg F, Gerber NK, Shivers S, Vicini FA
Ann Surg Oncol 2021 Oct;28(11):5974-5984. Epub 2021 Apr 5 doi: 10.1245/s10434-021-09903-1. PMID: 33821346Free PMC Article
Hypofractionated Versus Standard Fractionated Radiotherapy in Patients With Early Breast Cancer or Ductal Carcinoma In Situ in a Randomized Phase III Trial: The DBCG HYPO Trial.
Offersen BV, Alsner J, Nielsen HM, Jakobsen EH, Nielsen MH, Krause M, Stenbygaard L, Mjaaland I, Schreiber A, Kasti UM, Overgaard J; Danish Breast Cancer Group Radiation Therapy Committee
J Clin Oncol 2020 Nov 1;38(31):3615-3625. Epub 2020 Sep 10 doi: 10.1200/JCO.20.01363. PMID: 32910709
Breast Cancer-Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.
Giuliano AE, Connolly JL, Edge SB, Mittendorf EA, Rugo HS, Solin LJ, Weaver DL, Winchester DJ, Hortobagyi GN
CA Cancer J Clin 2017 Jul 8;67(4):290-303. Epub 2017 Mar 14 doi: 10.3322/caac.21393. PMID: 28294295
Surgical Excision Without Radiation for Ductal Carcinoma in Situ of the Breast: 12-Year Results From the ECOG-ACRIN E5194 Study.
Solin LJ, Gray R, Hughes LL, Wood WC, Lowen MA, Badve SS, Baehner FL, Ingle JN, Perez EA, Recht A, Sparano JA, Davidson NE
J Clin Oncol 2015 Nov 20;33(33):3938-44. Epub 2015 Sep 14 doi: 10.1200/JCO.2015.60.8588. PMID: 26371148Free PMC Article

Clinical prediction guides

Ductal Carcinoma In Situ - Quo Vadis?
Peltecu G
Chirurgia (Bucur) 2021 Dec;116(5 Suppl):S5-S6. PMID: 34967322
Randomized Phase III Trial Evaluating Radiation Following Surgical Excision for Good-Risk Ductal Carcinoma In Situ: Long-Term Report From NRG Oncology/RTOG 9804.
McCormick B, Winter KA, Woodward W, Kuerer HM, Sneige N, Rakovitch E, Smith BL, Germain I, Hartford AC, O'Rourke MA, Walker EM, Strom EA, Hopkins JO, Pierce LJ, Pu AT, Sumida KNM, Vesprini D, Moughan J, White JR
J Clin Oncol 2021 Nov 10;39(32):3574-3582. Epub 2021 Aug 18 doi: 10.1200/JCO.21.01083. PMID: 34406870Free PMC Article
The Clinical Utility of DCISionRT(®) on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery.
Shah C, Bremer T, Cox C, Whitworth P, Patel R, Patel A, Brown E, Gold L, Rock D, Riley L, Kesslering C, Brown S, Gabordi R, Pellicane J, Rabinovich R, Khan S, Templeton S, Majithia L, Willey SC, Wärnberg F, Gerber NK, Shivers S, Vicini FA
Ann Surg Oncol 2021 Oct;28(11):5974-5984. Epub 2021 Apr 5 doi: 10.1245/s10434-021-09903-1. PMID: 33821346Free PMC Article
Breast Cancer-Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.
Giuliano AE, Connolly JL, Edge SB, Mittendorf EA, Rugo HS, Solin LJ, Weaver DL, Winchester DJ, Hortobagyi GN
CA Cancer J Clin 2017 Jul 8;67(4):290-303. Epub 2017 Mar 14 doi: 10.3322/caac.21393. PMID: 28294295
RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation.
McCormick B, Winter K, Hudis C, Kuerer HM, Rakovitch E, Smith BL, Sneige N, Moughan J, Shah A, Germain I, Hartford AC, Rashtian A, Walker EM, Yuen A, Strom EA, Wilcox JL, Vallow LA, Small W Jr, Pu AT, Kerlin K, White J
J Clin Oncol 2015 Mar 1;33(7):709-15. Epub 2015 Jan 20 doi: 10.1200/JCO.2014.57.9029. PMID: 25605856Free PMC Article

Recent systematic reviews

Mammographic density, endocrine therapy and breast cancer risk: a prognostic and predictive biomarker review.
Atakpa EC, Thorat MA, Cuzick J, Brentnall AR
Cochrane Database Syst Rev 2021 Oct 26;10(10):CD013091. doi: 10.1002/14651858.CD013091.pub2. PMID: 34697802Free PMC Article
Benefits and harms of breast cancer screening with mammography in women aged 40-49 years: A systematic review.
van den Ende C, Oordt-Speets AM, Vroling H, van Agt HME
Int J Cancer 2017 Oct 1;141(7):1295-1306. Epub 2017 Jun 5 doi: 10.1002/ijc.30794. PMID: 28542784
Is sentinel lymph node biopsy indicated in patients with a diagnosis of ductal carcinoma in situ? A systematic literature review and meta-analysis.
El Hage Chehade H, Headon H, Wazir U, Abtar H, Kasem A, Mokbel K
Am J Surg 2017 Jan;213(1):171-180. Epub 2016 Sep 6 doi: 10.1016/j.amjsurg.2016.04.019. PMID: 27773373
Nipple- and areola-sparing mastectomy for the treatment of breast cancer.
Mota BS, Riera R, Ricci MD, Barrett J, de Castria TB, Atallah ÁN, Bevilacqua JL
Cochrane Database Syst Rev 2016 Nov 29;11(11):CD008932. doi: 10.1002/14651858.CD008932.pub3. PMID: 27898991Free PMC Article
Post-operative radiotherapy for ductal carcinoma in situ of the breast--a systematic review of the randomised trials.
Goodwin A, Parker S, Ghersi D, Wilcken N
Breast 2009 Jun;18(3):143-9. Epub 2009 May 17 doi: 10.1016/j.breast.2009.04.003. PMID: 19447038

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