Why the term of low-grade ductal carcinoma in situ should be abandoned: minimizing over diagnosis and overtreatment

Cancer Science & Therapy

ISSN: 1948-5956

Open Access

Why the term of low-grade ductal carcinoma in situ should be abandoned: minimizing over diagnosis and overtreatment

2nd World Congress on Breast Cancer

September 19-21, 2016 Phoenix, USA

Shahla Masood

University of Florida College of Medicine ├ó┬?┬? Jacksonville, USA

Keynote: J Cancer Sci Ther

Abstract :

During the last several years, increased public awareness, advances in breast imaging and enhanced screening programs have led to early breast cancer detection and attention to cancer prevention. The numbers of image-detected biopsies have increased and pathologists are expected to provide more information with smaller tissue samples. These biopsies have resulted in detection of increasing numbers of high-risk proliferative breast disease and in situ cancers. The general hypothesis is that some forms of breast cancers may arise from established forms of ductal carcinoma in situ (DCIS) and atypical ductal hyperplasia (ADH) and possibly from more common forms of ductal hyperplasia. However, this is an oversimplification of a very complex process, given the fact that the majority of breast cancers appears to arise de-novo or from a yet unknown precursor lesion. Currently, ADH and DCIS are considered as morphologic risk factors and precursor lesions for breast cancer. However, morphologic distinction between these two entities has remained a real issue that continues to lead to over-diagnosis and overtreatment. Aside from morphologic similarities between ADH and low grade DCIS, biomarker studies and molecular genetic testing├ó┬?┬?s have shown that morphologic overlaps are reflected at the molecular levels and raise questions about the validity of separating these two entities. It is hoped that as we better understand the genetic basis of these entities in relation to ultimate patient outcome, the suggested use of the term of ├ó┬?┬?Borderline Breast Disease├ó┬?┬Ł can minimize the number of patients who are subject to over treatment.

Biography :

Shahla Masood, M.D. is an professor in the department of Pathology and Laboratory Medicine at the University of Florida College of Medicine–Jacksonville. She is Chair, Department of Pathology and Laboratory Medicine; Program Director, Breast Pathology Fellowship; Medical Director, Breast Health Center; Program Director, Cytopathology Fellowship; Director of Research. Clinical Special Interests: Breast pathology, cytopathology. Research Special Interests: Early breast cancer detection; use of minimally invasive procedures to provide optimal samples for analysis; prognostic/predictive index.


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