| The management of ductal intraepithelial neoplasia (DIN): open controversies and guidelines of the Istituto Europeo di Oncologia (IEO), Milan, Italy. | |
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MedLine Citation:
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PMID: 20740312 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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The management of ductal intraepithelial neoplasia (DIN) has substantially changed over the past 30 years, as its incidence has increased (from 2-3% to more than 20%), mainly due to the widespread use of mammography screening. This article describes not only the more widespread theoretical concepts on DIN but also the differences in the practical applications of the theory between different countries, different oncology specialists, and different cancer centers. Papers related to the international multicentric-randomized trials and retrospective studies were analyzed. We include articles and papers published between 1993 and 2010 related to patients with DIN, and abstracts and reports from MEDLINE and other sources were indentified. The standard of care for DIN consists of (a) breast conservative surgery (mastectomy is still indicated in large lesions-masses or microcalcifications-in about 30% of cases); (b) radiotherapy (RT) after conservative surgery, and (c) medical treatment in estrogen receptors-positive patients. However, most studies have shown significant differences between theory and practical application. Moreover, there are differences regarding (a) the indications of sentinel lymph node biopsy, (b) the definition and identification of low-risk DIN subgroups that can avoid RT and tamoxifen, and (c) the research into new alternative drugs in adjuvant medical therapy. A general agreement on the best management of DIN does not exist as yet. New large trials are needed in order to define the best management of DIN patients which is (in most respects) still complex and controversial. |
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Authors:
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Gabriel Farante; Stefano Zurrida; Viviana Galimberti; Paolo Veronesi; Giuseppe Curigliano; Alberto Luini; Aron Goldhirsch; Umberto Veronesi |
Publication Detail:
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Type: Journal Article Date: 2010-08-26 |
Journal Detail:
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Title: Breast cancer research and treatment Volume: 128 ISSN: 1573-7217 ISO Abbreviation: Breast Cancer Res. Treat. Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8111104 Medline TA: Breast Cancer Res Treat Country: Netherlands |
Other Details:
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Languages: eng Pagination: 369-78 Citation Subset: IM |
Affiliation:
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Division of Senology, European Institute of Oncology, IEO, Via Ripamonti 435, 20141, Milan, Italy, gabriel.farante@ieo.it. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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