Local management of ductal carcinoma insitu

By increasing screening mammography, we observe increase in incidence of ductal carcinoma insitu (DCIS). Historically we see so many changes in management of this tumor. The National Surgical Adjuvant Breast and Bowel Project (NSABP) B-17, the European Organization for Research and Treatment of Cancer(EORTC) 10853, the UK/Australia/New Zealand (UK/ANZ) cooperative trial , and the Swedish trial. All suggest a benefit in local control with the addition of whole-breast radiation compared with lumpectomyalone (with or without tamoxifen). Now there are some debate on local management and even systemic treatment. In this paper we review the scoring system for recurrence risk assessment based on margin, size, pathological classification and age. We discuss evidence for management and guidlines comparison. Finally we explain summary of ongoing trials of DCIS: RTOG 1005, TROG07.01, BIG03-07, IBCSG 38- 10 and BONBIS Also there is some discussion on some especial situation such as micro invasive carcinoma in a mass of in situ carcinoma its management. No need to more systemic treatment