Rethinking ductal carcinoma in situ (DCIS)
Dr. Matthew Wallis (Cambridge, UK) during the refresh course on “Rethinking ductal carcinoma in situ (DCIS)” at ECR 2018 presented the importance of setting up a “no treatment trial” in order to manage the rising number of “over-diagnosis” for DCIS.
Due to the widespread use of screening, the number of women diagnosed with DCIS is increasing. Long-term follow-up shows that there is a large group of DCIS that never progresses within patients’ lifetime, which means we have either cured them or overtreat them.
Dr. Wallis went through the randomized controlled trials running internationally at the time being: LORIS (The LOw RISk DCIS trial), LORD (LOw Risk DCIS), COMET (Comparison of Operative versus Medical Endocrine Therapy for Low Risk DCIS) and LORETTA a single-arm confirmatory study of endocrine treatment only. The lecture mainly focused on how to identify markers for progression from retrospective data sets, set up a ‘no treatment trial’ and evaluate “active monitoring” as alternative option for surgery as first step, but treat if disease is progressing but still curable.
Listen to the lecture via ECR Online (http://ecronline.myesr.org/ecr2018/)