The Natural History of Ductal Carcinoma In Situ of the Breast - An Overview

Ductal carcinoma in situ (DCIS) of the breast is a heterogenous disease and its natural history cannot be directly observed as surgical removal is part of the current standard of care. Studies of incompletely excised breast lesions that were considered benign after biopsy, but at review years later were recognized as DCIS, offers some insight to the natural history of DCIS. Summarizing these retrospective data; 14-53 % of the cases retrospectively diagnosed as DCIS progressed to invasive breast cancer (IBC) during follow-up. While observations from retrospective re-evaluation of biopsies and autopsies adds epidemiological input for understanding the natural history of DCIS, the most important results are still awaited from the ongoing prospective studies on active surveillance of DCIS. These studies with collected data on patient characteristics, life-style and environmental factors, as well as tumor and stromal metabolomics and genomics, will probably further elucidate the natural history of DCIS and how the disease should be treated in the future.