National Institutes of Health State-of-the-Science Conference Statement: Diagnosis and Management of Ductal Carcinoma In Situ September 22-24, 2009

被引：173

作者：

Allegra, Carmen J. ^{[1
]}

Aberle, Denise R. ^{[2
]}

Ganschow, Pamela ^{[3
,4
]}

Hahn, Stephen M. ^{[5
]}

Lee, Clara N. ^{[6
]}

Millon-Underwood, Sandra ^{[7
]}

Pike, Malcolm C. ^{[8
,9
]}

Reed, Susan D. ^{[10
,11
]}

Saftlas, Audrey F. ^{[12
]}

Scarvalone, Susan A. ^{[13
]}

Schwartz, Arnold M. ^{[14
]}

Slomski, Carol ^{[15
]}

Yothers, Greg ^{[16
,17
]}

Zon, Robin ^{[18
,19
]}

机构：

[1] Univ Florida, Dept Med, Shands Canc Ctr, Gainesville, FL 32610 USA

[2] Univ Calif Los Angeles, David Geffen Sch Med, Dept Radiol Sci, Los Angeles, CA 90095 USA

[3] John H Stroger Jr Hosp Cook Cty, Breast & Cerv Canc Screening Program, Chicago, IL USA

[4] Rush Univ, Med Ctr, Chicago, IL 60612 USA

[5] Univ Penn, Sch Med, Dept Radiat Oncol, Philadelphia, PA 19104 USA

[6] Univ N Carolina, Dept Surg, Div Plast & Reconstruct Surg, Sch Med, Chapel Hill, NC USA

[7] Univ Wisconsin, Coll Nursing, Milwaukee, WI 53201 USA

[8] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA

[9] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA

[10] Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98195 USA

[11] Univ Washington, Dept Epidemiol, Fred Hutchinson Canc Res Ctr, Seattle, WA 98195 USA

[12] Univ Iowa, Dept Epidemiol, Coll Publ Hlth, Iowa City, IA USA

[13] St Johns Mercy Med Ctr, Harry & Jeanette Weinberg Ctr, Prevent & Res Ctr, Baltimore, MD USA

[14] George Washington Univ, Med Ctr, Dept Pathol, Washington, DC 20037 USA

[15] Great Lakes Breast Care, Lansing, MI USA

[16] Univ Pittsburgh, Dept Biostat, Pittsburgh, PA 15261 USA

[17] Univ Pittsburgh, Natl Surg Adjuvant Breast & Bowel Project NSABP, Ctr Biostat, Pittsburgh, PA 15261 USA

[18] No Indiana Canc Res Consortium, South Bend, IN USA

[19] Mem Hosp, South Bend, IN USA

来源：

JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2010年 / 102卷 / 03期

关键词：

D O I：

10.1093/jnci/djp485

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective To provide health-care providers, patients, and the general public with a responsible assessment of currently available data on the diagnosis and management of ductal carcinoma in situ (DCIS). Participants A non-Department of Health and Human Services, nonadvocate, 14-member panel representing the fields of oncology, radiology, surgery (general and reconstructive), pathology, radiation oncology, internal medicine, epidemiology, biostatistics, nursing, obstetrics and gynecology, preventative medicine and population health, and social work. In addition, 22 experts from pertinent fields presented data to the panel and conference audience. Evidence Presentations by experts and a systematic review of the literature prepared by the Minnesota Evidence-based Practice Center, through the Agency for Healthcare Research and Quality. Scientific evidence was given precedence over anecdotal experience. Conference process The panel drafted its statement based on scientific evidence presented in open forum and on published scientific literature. The draft statement was presented on the final day of the conference and circulated to the audience for comment. The panel released a revised statement later that day at http://consensus.nih.gov. This statement is an independent report of the panel and is not a policy statement of the National Institutes of Health or the Federal Government. Conclusions Clearly, the diagnosis and management of DCIS is highly complex with many unanswered questions, including the fundamental natural history of untreated disease. Because of the noninvasive nature of DCIS, coupled with its favorable prognosis, strong consideration should be given to elimination of the use of the anxiety-producing term "carcinoma" from the description of DCIS. The outcomes in women treated with available therapies are excellent. Thus, the primary question for future research must focus on the accurate identification of patient subsets diagnosed with DCIS, including those persons who may be managed with less therapeutic intervention without sacrificing the excellent outcomes presently achieved. Essential in this quest will be the development and validation of accurate risk stratification methods based on a comprehensive understanding of the clinical, pathological, and biological factors associated with DCIS.

引用

页码：161 / 169

页数：9