The comparison of treatment and diagnosis in guidelines about the pure noninvasive breast carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Jie ¹ ,  LÜ Qing ¹ , WANG Zhu ²

1. Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Laboratory of Tumor Molecular Diagnosis, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LÜ Qing, Email: lqlq1963@163.com

Keywords：

breast cancer; carcinoma in situ; guideline; comparison

DOI：

10.7507/1007-9424.201701037

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the description about the pure noninvasive breast carcinoman in guidelines. Methods The related guidelines and literatures about the pure noninvasive breast carcinoma were collected to make a review. Results Through reviewing the guidelines of breast carcinoma, including Chinese Anti Cancer Association (CACA), National Comprehensive Cancer Network (NCCN), St.Gallen, European Society for Medical Oncology Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up, as well as Japanese Breast Cancer Society Clinical Practice Guideline, we find that, the main treatment of noninvasive breast carcinoma is operation and the surgery for axillary is not recommended by most guidelines. The sentinel lymph node biopsy (SLNB) should be performed only when the invasive ductal carcinoma (IDC) is suspected or location of lesion would decrease the success of SLNB in the future. The radiotherapy should be advised to patients following conservation surgery. The patients with estrogen receptor (ER)-positive should undergo endocrine therapy. However, the using of endocrine therapy should be discussed with patient. Conclusions Although the prognosis of pure noninvasive breast carcinoma is better than invasive cancer, the research about it is still less, and the treatments recommended by guidelines are different. The more attention should be paid to the research about the pure noninvasive carcinoma.

Citation： CHEN Jie, LÜ Qing, WANG Zhu. The comparison of treatment and diagnosis in guidelines about the pure noninvasive breast carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(11): 1400-1407. doi: 10.7507/1007-9424.201701037 Copy

1.	Narod SA, Iqbal J, Giannakeas V, et al. Breast cancer mortality after a diagnosis of ductal carcinoma in situ. JAMA Oncol, 2015, 1(7): 888-896.
2.	Worni M, Akushevich I, Greenup R, et al. Trends in treatment patterns and outcomes for ductal carcinoma in situ. J Natl Cancer Inst, 2015, 107(12): djv263.
3.	Selvi R. Breast diseases-imaging and clinical management. New York: Springer, 2015: 257-268.
4.	Kerlikowske K. Epidemiology of ductal carcinoma in situ. J Natl Cancer Inst Monographs, 2010, 2010(41): 139-141.
5.	王颀, 连臻强, 郭子柏. 乳腺导管原位癌发病率、治疗和预后的系统评价. 循证医学, 2011, 11(3): 148-151.
6.	中国抗癌协会乳腺专业委员会. 中国抗癌协会乳腺癌诊治指南与规范. 中国癌症杂志, 2015, 25(9): 692-754.
7.	King TA, Pilewskie M, Muhsen S, et al. Lobular carcinoma in situ: a 29-year longitudinal experience evaluating clinicopathologic features and breast cancer risk. J Clin Oncol, 2015, 33(33): 3945-3952.
8.	NCCN. NCCN clinical practice guideline in oncology breast cacner. Versison 2. 2016. 2016-08-06. https://www.nccn.org/professionals/physician_gls/f_guidelines.asp.
9.	Wang L, Xia Y, Liu D, et al. Evaluating the efficacy of post-surgery adjuvant therapies used for ductal carcinoma in situ patients: a network meta-analysis. Oncotarget, 2017, [Epub ahead of print].
10.	Ignatiadis M, Buyse M, Sotiriou C. St Gallen International Expert Consensus on the primary therapy of early breast cancer: an invaluable tool for physicians and scientists. Ann Oncol, 2015, 26(8): 1519-1520.
11.	Renshaw AA, Derhagopian RP, Martinez P, et al. Lobular neoplasia in breast core needle biopsy specimens is associated with a low risk of ductal carcinoma in situ or invasive carcinoma on subsequent excision. Am J Clin Pathol, 2006, 126(2): 310-313.
12.	Nagi CS, O’Donnell JE, Tismenetsky M, et al. Lobular neoplasia on core needle biopsy does not require excision. Cancer, 2008, 112(10): 2152-2158.
13.	Hwang H, Barke LD, Mendelson EB, et al. Atypical lobular hyperplasia and classic lobular carcinoma in situ in core biopsy specimens: routine excision is not necessary. Mod Pathol, 2008, 21(10): 1208-1216.
14.	Elsheikh TM, Silverman JF. Follow-up surgical excision is indicated when breast core needle biopsies show atypical lobular hyperplasia or lobular carcinoma in situ: a correlative study of 33 patients with review of the literature. Am J Surg Pathol, 2005, 29(4): 534-543.
15.	Karabakhtsian RG, Johnson R, Sumkin J, et al. The clinical significance of lobular neoplasia on breast core biopsy. Am J Surg Pathol, 2007, 31(5): 717-723.
16.	O’Neil M, Madan R, Tawfik OW, et al. Lobular carcinoma in situ/atypical lobular hyperplasia on breast needle biopsies: does it warrant surgical excisional biopsy? A study of 27 cases. Ann Diagn Pathol, 2010, 14(4): 251-255.
17.	Foster MC, Helvie MA, Gregory NE, et al. Lobular carcinoma in situ or atypical lobular hyperplasia at core-needle biopsy: is excisional biopsy necessary? Radiology, 2004, 231(3): 813-819.
18.	Anderson BO, Calhoun KE, Rosen EL. Evolving concepts in the management of lobular neoplasia. J Natl Compr Canc Netw, 2006, 4(5): 511-522.
19.	Kuhl CK, Schrading S, Bieling HB, et al. MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet, 2007, 370(9586): 485-492.
20.	Kowalchik KV, Vallow LA, McDonough M, et al. The role of preoperative bilateral breast magnetic resonance imaging in patient selection for partial breast irradiation in ductal carcinoma in situ. Int J Surg Oncol, 2012, 2012: 206342.
21.	Walters LL, Pang JC, Zhao L, et al. Ductal carcinoma in situ with distorting sclerosis on core biopsy may be predictive of upstaging on excision. Histopathology, 2015, 66(4): 577-586.
22.	Waddell BE, Stomper PC, DeFazio JL, et al. Postexcision mammography is indicated after resection of ductal carcinoma-in-situ of the breast. Ann Surg Oncol, 2000, 7(9): 665-668.
23.	Chesney TR, Yin JX, Rajaee N, et al. Tamoxifen with radiotherapy compared with tamoxifen alone in elderly women with early-stage breast cancer treated with breast conserving surgery: a systematic review and meta-analysis. Radiother Oncol, 2017, 123(1): 1-9.
24.	EORTC Breast Cancer Cooperative Group; EORTC Radiotherapy Group; Bijker N, et al. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phaseⅢ trial 10853—a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. J Clin Oncol, 2006, 24(21): 3381-3387.
25.	Emdin SO, Granstrand B, Ringberg A, et al. SweDCIS: radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomised trial in a population offered mammography screening. Acta Oncol, 2006, 45(5): 536-543.
26.	Fisher B, Dignam J, Wolmark N, et al. Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17. J Clin Oncol, 1998, 16(2): 441-452.
27.	Houghton J, George WD, Cuzick J, et al. Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK, Australia, and New Zealand: randomised controlled trial. Lancet, 2003, 362(9378): 95-102.
28.	Julien JP, Bijker N, Fentiman IS, et al. Radiotherapy in breast-conserving treatment for ductal carcinoma in situ: first results of the EORTC randomised phase Ⅲ trial 10853. EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. Lancet, 2000, 355(9203): 528-533.
29.	Cuzick J, Sestak I, Pinder SE, et al. Effect of tamoxifen and radiotherapy in women with locally excised ductal carcinoma in situ: long-term results from the UK/ANZ DCIS trial. Lancet Oncol, 2011, 12(1): 21-29.
30.	Di Saverio S, Catena F, Santini D, et al. 259 patients with DCIS of the breast applying USC/Van Nuys prognostic index: a retrospective review with long term follow up. Breast Cancer Res Treat, 2008, 109(3): 405-416.
31.	Gilleard O, Goodman A, Cooper M, et al. The significance of the Van Nuys prognostic index in the management of ductal carcinoma in situ. World J Surg Oncol, 2008, 6: 61.
32.	Silverstein MJ, Lagios MD, Craig PH, et al. A prognostic index for ductal carcinoma in situ of the breast. Cancer, 1996, 77(11): 2267-2274.
33.	Silverstein MJ, Lagios MD, Groshen S, et al. The influence of margin width on local control of ductal carcinoma in situ of the breast. N Engl J Med, 1999, 340(19): 1455-1461.
34.	Wong JS, Chen YH, Gadd MA, et al. Eight-year update of a prospective study of wide excision alone for small low-or intermediate-grade ductal carcinoma in situ (DCIS). Breast Cancer Res Treat, 2014, 143(2): 343-350.
35.	Goodwin A, Parker S, Ghersi D, et al. Post-operative radiotherapy for ductal carcinoma in situ of the breast——a systematic review of the randomised trials. Breast, 2009, 18(3): 143-149.
36.	Wärnberg F, Garmo H, Emdin S, et al. Effect of radiotherapy after breast-conserving surgery for ductal carcinoma in situ: 20 years follow-up in the randomized SweDCIS Trial. J Clin Oncol, 2014, 32(32): 3613-3618.
37.	Wapnir IL, Dignam JJ, Fisher B, et al. Long-term outcomes of invasive ipsilateral breast tumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS. J Natl Cancer Inst, 2011, 103(6): 478-488.
38.	Carraro DM, Elias EV, Andrade VP. Ductal carcinoma in situ of the breast: morphological and molecular features implicated in progression. Biosci Rep, 2014, 34(1): e00090.
39.	Forbes JF, Sestak I, Howell A, et al. Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-Ⅱ DCIS): a double-blind, randomised controlled trial. Lancet, 2016, 387(10021): 866-873.
40.	Wapnir IL, Aebi S, Gelber S, et al. Progress on BIG 1-02/IBCSG 27-02/NSABP B-37, a prospective randomized trial evaluating chemotherapy after local therapy for isolated locoregional recurrences of breast cancer. Ann Surg Oncol, 2008, 15(11): 3227-3231.
41.	Kerlikowske K, Molinaro AM, Gauthier ML, et al. Biomarker expression and risk of subsequent tumors after initial ductal carcinoma in situ diagnosis. J Natl Cancer Inst, 2010, 102(9): 627-637.
42.	Stackievicz R, Paran H, Bernheim J, et al. Prognostic significance of HER-2/neu expression in patients with ductal carcinoma in situ. Isr Med Assoc J, 2010, 12(5): 290-295.
43.	Zhou W, Jirström K, Johansson C, et al. Long-term survival of women with basal-like ductal carcinoma in situ of the breast: a population-based cohort study. BMC Cancer, 2010, 10: 653.
44.	Lari SA, Kuerer HM. Biological markers in DCIS and risk of breast recurrence: a systematic review. J Cancer, 2011, 2: 232-261.
45.	Moran MS, Schnitt SJ, Giuliano AE, et al. Society of Surgical Oncology-American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stagesⅠ andⅡ invasive breast cancer. J Clin Oncol, 2014, 32(14): 1507-1515.
46.	Houssami N, Morrow M. Margins in breast conservation: a clinician’s perspective and what the literature tells us. J Surg Oncol, 2014, 110(1): 2-7.
47.	Senkus E, Kyriakides S, Ohno S, et al. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2015, 26 Suppl 5: v8-v30.
48.	Houssami N, Macaskill P, Marinovich ML, et al. Meta-analysis of the impact of surgical margins on local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy. Eur J Cancer, 2010, 46(18): 3219-3232.
49.	Leidenius M, Salmenkivi K, von Smitten K, et al. Tumour-positive sentinel node findings in patients with ductal carcinoma in situ. J Surg Oncol, 2006, 94(5): 380-384.
50.	Moore KH, Sweeney KJ, Wilson ME, et al. Outcomes for women with ductal carcinoma-in-situ and a positive sentinel node: a multi-institutional audit. Ann Surg Oncol, 2007, 14(10): 2911-2917.
51.	Meijnen P, Oldenburg HS, Loo CE, et al. Risk of invasion and axillary lymph node metastasis in ductal carcinoma in situ diagnosed by core-needle biopsy. Br J Surg, 2007, 94(8): 952-956.
52.	Yen TW, Hunt KK, Ross MI, et al. Predictors of invasive breast cancer in patients with an initial diagnosis of ductal carcinoma in situ: a guide to selective use of sentinel lymph node biopsy in management of ductal carcinoma in situ.. J Am Coll Surg, 2005, 200(4): 516-526.
53.	Staley H, McCallum I, Bruce J. Postoperative tamoxifen for ductal carcinoma in situ. Cochrane Database Syst Rev, 2012, 10: CD007847.
54.	Komoike Y, Inokuchi M, Itoh T, et al. Japan Breast Cancer Society clinical practice guideline for surgical treatment of breast cancer. Breast Cancer, 2015, 22(1): 37-48.
55.	Borgquist S, Zhou W, Jirström K, et al. The prognostic role of HER2 expression in ductal breast carcinoma in situ (DCIS); a population-based cohort study. BMC Cancer, 2015, 15: 468.
56.	Latta EK, Tjan S, Parkes RK, et al. The role of HER2/neu overexpression/amplification in the progression of ductal carcinoma in situ to invasive carcinoma of the breast. Mod Pathol, 2002, 15(12): 1318-1325.

1. Narod SA, Iqbal J, Giannakeas V, et al. Breast cancer mortality after a diagnosis of ductal carcinoma in situ. JAMA Oncol, 2015, 1(7): 888-896.
2. Worni M, Akushevich I, Greenup R, et al. Trends in treatment patterns and outcomes for ductal carcinoma in situ. J Natl Cancer Inst, 2015, 107(12): djv263.
3. Selvi R. Breast diseases-imaging and clinical management. New York: Springer, 2015: 257-268.
4. Kerlikowske K. Epidemiology of ductal carcinoma in situ. J Natl Cancer Inst Monographs, 2010, 2010(41): 139-141.
5. 王颀, 连臻强, 郭子柏. 乳腺导管原位癌发病率、治疗和预后的系统评价. 循证医学, 2011, 11(3): 148-151.
6. 中国抗癌协会乳腺专业委员会. 中国抗癌协会乳腺癌诊治指南与规范. 中国癌症杂志, 2015, 25(9): 692-754.
7. King TA, Pilewskie M, Muhsen S, et al. Lobular carcinoma in situ: a 29-year longitudinal experience evaluating clinicopathologic features and breast cancer risk. J Clin Oncol, 2015, 33(33): 3945-3952.
8. NCCN. NCCN clinical practice guideline in oncology breast cacner. Versison 2. 2016. 2016-08-06. https://www.nccn.org/professionals/physician_gls/f_guidelines.asp.
9. Wang L, Xia Y, Liu D, et al. Evaluating the efficacy of post-surgery adjuvant therapies used for ductal carcinoma in situ patients: a network meta-analysis. Oncotarget, 2017, [Epub ahead of print].
10. Ignatiadis M, Buyse M, Sotiriou C. St Gallen International Expert Consensus on the primary therapy of early breast cancer: an invaluable tool for physicians and scientists. Ann Oncol, 2015, 26(8): 1519-1520.
11. Renshaw AA, Derhagopian RP, Martinez P, et al. Lobular neoplasia in breast core needle biopsy specimens is associated with a low risk of ductal carcinoma in situ or invasive carcinoma on subsequent excision. Am J Clin Pathol, 2006, 126(2): 310-313.
12. Nagi CS, O’Donnell JE, Tismenetsky M, et al. Lobular neoplasia on core needle biopsy does not require excision. Cancer, 2008, 112(10): 2152-2158.
13. Hwang H, Barke LD, Mendelson EB, et al. Atypical lobular hyperplasia and classic lobular carcinoma in situ in core biopsy specimens: routine excision is not necessary. Mod Pathol, 2008, 21(10): 1208-1216.
14. Elsheikh TM, Silverman JF. Follow-up surgical excision is indicated when breast core needle biopsies show atypical lobular hyperplasia or lobular carcinoma in situ: a correlative study of 33 patients with review of the literature. Am J Surg Pathol, 2005, 29(4): 534-543.
15. Karabakhtsian RG, Johnson R, Sumkin J, et al. The clinical significance of lobular neoplasia on breast core biopsy. Am J Surg Pathol, 2007, 31(5): 717-723.
16. O’Neil M, Madan R, Tawfik OW, et al. Lobular carcinoma in situ/atypical lobular hyperplasia on breast needle biopsies: does it warrant surgical excisional biopsy? A study of 27 cases. Ann Diagn Pathol, 2010, 14(4): 251-255.
17. Foster MC, Helvie MA, Gregory NE, et al. Lobular carcinoma in situ or atypical lobular hyperplasia at core-needle biopsy: is excisional biopsy necessary? Radiology, 2004, 231(3): 813-819.
18. Anderson BO, Calhoun KE, Rosen EL. Evolving concepts in the management of lobular neoplasia. J Natl Compr Canc Netw, 2006, 4(5): 511-522.
19. Kuhl CK, Schrading S, Bieling HB, et al. MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet, 2007, 370(9586): 485-492.
20. Kowalchik KV, Vallow LA, McDonough M, et al. The role of preoperative bilateral breast magnetic resonance imaging in patient selection for partial breast irradiation in ductal carcinoma in situ. Int J Surg Oncol, 2012, 2012: 206342.
21. Walters LL, Pang JC, Zhao L, et al. Ductal carcinoma in situ with distorting sclerosis on core biopsy may be predictive of upstaging on excision. Histopathology, 2015, 66(4): 577-586.
22. Waddell BE, Stomper PC, DeFazio JL, et al. Postexcision mammography is indicated after resection of ductal carcinoma-in-situ of the breast. Ann Surg Oncol, 2000, 7(9): 665-668.
23. Chesney TR, Yin JX, Rajaee N, et al. Tamoxifen with radiotherapy compared with tamoxifen alone in elderly women with early-stage breast cancer treated with breast conserving surgery: a systematic review and meta-analysis. Radiother Oncol, 2017, 123(1): 1-9.
24. EORTC Breast Cancer Cooperative Group; EORTC Radiotherapy Group; Bijker N, et al. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phaseⅢ trial 10853—a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. J Clin Oncol, 2006, 24(21): 3381-3387.
25. Emdin SO, Granstrand B, Ringberg A, et al. SweDCIS: radiotherapy after sector resection for ductal carcinoma in situ of the breast. Results of a randomised trial in a population offered mammography screening. Acta Oncol, 2006, 45(5): 536-543.
26. Fisher B, Dignam J, Wolmark N, et al. Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17. J Clin Oncol, 1998, 16(2): 441-452.
27. Houghton J, George WD, Cuzick J, et al. Radiotherapy and tamoxifen in women with completely excised ductal carcinoma in situ of the breast in the UK, Australia, and New Zealand: randomised controlled trial. Lancet, 2003, 362(9378): 95-102.
28. Julien JP, Bijker N, Fentiman IS, et al. Radiotherapy in breast-conserving treatment for ductal carcinoma in situ: first results of the EORTC randomised phase Ⅲ trial 10853. EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. Lancet, 2000, 355(9203): 528-533.
29. Cuzick J, Sestak I, Pinder SE, et al. Effect of tamoxifen and radiotherapy in women with locally excised ductal carcinoma in situ: long-term results from the UK/ANZ DCIS trial. Lancet Oncol, 2011, 12(1): 21-29.
30. Di Saverio S, Catena F, Santini D, et al. 259 patients with DCIS of the breast applying USC/Van Nuys prognostic index: a retrospective review with long term follow up. Breast Cancer Res Treat, 2008, 109(3): 405-416.
31. Gilleard O, Goodman A, Cooper M, et al. The significance of the Van Nuys prognostic index in the management of ductal carcinoma in situ. World J Surg Oncol, 2008, 6: 61.
32. Silverstein MJ, Lagios MD, Craig PH, et al. A prognostic index for ductal carcinoma in situ of the breast. Cancer, 1996, 77(11): 2267-2274.
33. Silverstein MJ, Lagios MD, Groshen S, et al. The influence of margin width on local control of ductal carcinoma in situ of the breast. N Engl J Med, 1999, 340(19): 1455-1461.
34. Wong JS, Chen YH, Gadd MA, et al. Eight-year update of a prospective study of wide excision alone for small low-or intermediate-grade ductal carcinoma in situ (DCIS). Breast Cancer Res Treat, 2014, 143(2): 343-350.
35. Goodwin A, Parker S, Ghersi D, et al. Post-operative radiotherapy for ductal carcinoma in situ of the breast——a systematic review of the randomised trials. Breast, 2009, 18(3): 143-149.
36. Wärnberg F, Garmo H, Emdin S, et al. Effect of radiotherapy after breast-conserving surgery for ductal carcinoma in situ: 20 years follow-up in the randomized SweDCIS Trial. J Clin Oncol, 2014, 32(32): 3613-3618.
37. Wapnir IL, Dignam JJ, Fisher B, et al. Long-term outcomes of invasive ipsilateral breast tumor recurrences after lumpectomy in NSABP B-17 and B-24 randomized clinical trials for DCIS. J Natl Cancer Inst, 2011, 103(6): 478-488.
38. Carraro DM, Elias EV, Andrade VP. Ductal carcinoma in situ of the breast: morphological and molecular features implicated in progression. Biosci Rep, 2014, 34(1): e00090.
39. Forbes JF, Sestak I, Howell A, et al. Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-Ⅱ DCIS): a double-blind, randomised controlled trial. Lancet, 2016, 387(10021): 866-873.
40. Wapnir IL, Aebi S, Gelber S, et al. Progress on BIG 1-02/IBCSG 27-02/NSABP B-37, a prospective randomized trial evaluating chemotherapy after local therapy for isolated locoregional recurrences of breast cancer. Ann Surg Oncol, 2008, 15(11): 3227-3231.
41. Kerlikowske K, Molinaro AM, Gauthier ML, et al. Biomarker expression and risk of subsequent tumors after initial ductal carcinoma in situ diagnosis. J Natl Cancer Inst, 2010, 102(9): 627-637.
42. Stackievicz R, Paran H, Bernheim J, et al. Prognostic significance of HER-2/neu expression in patients with ductal carcinoma in situ. Isr Med Assoc J, 2010, 12(5): 290-295.
43. Zhou W, Jirström K, Johansson C, et al. Long-term survival of women with basal-like ductal carcinoma in situ of the breast: a population-based cohort study. BMC Cancer, 2010, 10: 653.
44. Lari SA, Kuerer HM. Biological markers in DCIS and risk of breast recurrence: a systematic review. J Cancer, 2011, 2: 232-261.
45. Moran MS, Schnitt SJ, Giuliano AE, et al. Society of Surgical Oncology-American Society for Radiation Oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stagesⅠ andⅡ invasive breast cancer. J Clin Oncol, 2014, 32(14): 1507-1515.
46. Houssami N, Morrow M. Margins in breast conservation: a clinician’s perspective and what the literature tells us. J Surg Oncol, 2014, 110(1): 2-7.
47. Senkus E, Kyriakides S, Ohno S, et al. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2015, 26 Suppl 5: v8-v30.
48. Houssami N, Macaskill P, Marinovich ML, et al. Meta-analysis of the impact of surgical margins on local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy. Eur J Cancer, 2010, 46(18): 3219-3232.
49. Leidenius M, Salmenkivi K, von Smitten K, et al. Tumour-positive sentinel node findings in patients with ductal carcinoma in situ. J Surg Oncol, 2006, 94(5): 380-384.
50. Moore KH, Sweeney KJ, Wilson ME, et al. Outcomes for women with ductal carcinoma-in-situ and a positive sentinel node: a multi-institutional audit. Ann Surg Oncol, 2007, 14(10): 2911-2917.
51. Meijnen P, Oldenburg HS, Loo CE, et al. Risk of invasion and axillary lymph node metastasis in ductal carcinoma in situ diagnosed by core-needle biopsy. Br J Surg, 2007, 94(8): 952-956.
52. Yen TW, Hunt KK, Ross MI, et al. Predictors of invasive breast cancer in patients with an initial diagnosis of ductal carcinoma in situ: a guide to selective use of sentinel lymph node biopsy in management of ductal carcinoma in situ.. J Am Coll Surg, 2005, 200(4): 516-526.
53. Staley H, McCallum I, Bruce J. Postoperative tamoxifen for ductal carcinoma in situ. Cochrane Database Syst Rev, 2012, 10: CD007847.
54. Komoike Y, Inokuchi M, Itoh T, et al. Japan Breast Cancer Society clinical practice guideline for surgical treatment of breast cancer. Breast Cancer, 2015, 22(1): 37-48.
55. Borgquist S, Zhou W, Jirström K, et al. The prognostic role of HER2 expression in ductal breast carcinoma in situ (DCIS); a population-based cohort study. BMC Cancer, 2015, 15: 468.
56. Latta EK, Tjan S, Parkes RK, et al. The role of HER2/neu overexpression/amplification in the progression of ductal carcinoma in situ to invasive carcinoma of the breast. Mod Pathol, 2002, 15(12): 1318-1325.

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The comparison of treatment and diagnosis in guidelines about the pure noninvasive breast carcinoma

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