ACR Appropriateness Criteria® Ductal Carcinoma in Situ
Identifieur interne : 004874 ( Main/Exploration ); précédent : 004873; suivant : 004875ACR Appropriateness Criteria® Ductal Carcinoma in Situ
Auteurs : Meena S. Moran [États-Unis] ; Harrison X. Bai [États-Unis] ; Eleanor E. R. Harris [États-Unis] ; Douglas W. Arthur [États-Unis] ; Lisa Bailey ; Jennifer R. Bellon [États-Unis] ; Lisa Carey ; Sharad Goyal [États-Unis] ; Michele Y. Halyard [États-Unis] ; Kathleen C. Horst [États-Unis] ; Shannon M. Macdonald [États-Unis] ; Bruce G. Haffty [États-Unis]Source :
- The Breast Journal [ 1075-122X ] ; 2012-01.
Abstract
Abstract: Ductal carcinoma in situ (DCIS) describes a wide spectrum of non‐invasive tumors which carry a significant risk of invasive relapse, thus prevention of local recurrence is vital. For appropriate patients with limited disease, management with breast conserving surgery (BCS) followed by whole‐breast radiation (RT) is supported by multiple Phase III studies, but mastectomy may be appropriate in selected patients. Omission of RT may also be reasonable in some patients, though which criteria are to be utilized remain unclear, and the existing data are contradictory with limited follow‐up. Various RT techniques such as boost to the tumor bed, partial breast radiation or hypofractionated, whole‐breast RT are increasingly utilized but the data to support their use specifically in DCIS is limited. Tamoxifen also increases local control for ER + DCIS, adding to the complexity of the local treatment management. This article reviews the existing scientific evidence, the controversies surrounding local management, and clinical guidelines for DCIS based on the group consensus by the ACR Breast Expert Panel. The American College of Radiology Appropriateness Criteria are evidence‐based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer‐reviewed journals and the application of a well established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
Url:
DOI: 10.1111/j.1524-4741.2011.01197.x
Affiliations:
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For appropriate patients with limited disease, management with breast conserving surgery (BCS) followed by whole‐breast radiation (RT) is supported by multiple Phase III studies, but mastectomy may be appropriate in selected patients. Omission of RT may also be reasonable in some patients, though which criteria are to be utilized remain unclear, and the existing data are contradictory with limited follow‐up. Various RT techniques such as boost to the tumor bed, partial breast radiation or hypofractionated, whole‐breast RT are increasingly utilized but the data to support their use specifically in DCIS is limited. Tamoxifen also increases local control for ER + DCIS, adding to the complexity of the local treatment management. This article reviews the existing scientific evidence, the controversies surrounding local management, and clinical guidelines for DCIS based on the group consensus by the ACR Breast Expert Panel. The American College of Radiology Appropriateness Criteria are evidence‐based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer‐reviewed journals and the application of a well established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Arizona</li><li>Californie</li><li>Connecticut</li><li>Floride</li><li>Massachusetts</li><li>New Jersey</li><li>Virginie</li></region></list><tree><noCountry><name sortKey="Bailey, Lisa" sort="Bailey, Lisa" uniqKey="Bailey L" first="Lisa" last="Bailey">Lisa Bailey</name><name sortKey="Carey, Lisa" sort="Carey, Lisa" uniqKey="Carey L" first="Lisa" last="Carey">Lisa Carey</name></noCountry><country name="États-Unis"><region name="Connecticut"><name sortKey="Moran, Meena S" sort="Moran, Meena S" uniqKey="Moran M" first="Meena S." last="Moran">Meena S. Moran</name></region><name sortKey="Arthur, Douglas W" sort="Arthur, Douglas W" uniqKey="Arthur D" first="Douglas W." last="Arthur">Douglas W. Arthur</name><name sortKey="Bai, Harrison X" sort="Bai, Harrison X" uniqKey="Bai H" first="Harrison X." last="Bai">Harrison X. Bai</name><name sortKey="Bellon, Jennifer R" sort="Bellon, Jennifer R" uniqKey="Bellon J" first="Jennifer R." last="Bellon">Jennifer R. Bellon</name><name sortKey="Goyal, Sharad" sort="Goyal, Sharad" uniqKey="Goyal S" first="Sharad" last="Goyal">Sharad Goyal</name><name sortKey="Haffty, Bruce G" sort="Haffty, Bruce G" uniqKey="Haffty B" first="Bruce G." last="Haffty">Bruce G. Haffty</name><name sortKey="Halyard, Michele Y" sort="Halyard, Michele Y" uniqKey="Halyard M" first="Michele Y." last="Halyard">Michele Y. Halyard</name><name sortKey="Harris, Eleanor E R" sort="Harris, Eleanor E R" uniqKey="Harris E" first="Eleanor E. R." last="Harris">Eleanor E. R. Harris</name><name sortKey="Horst, Kathleen C" sort="Horst, Kathleen C" uniqKey="Horst K" first="Kathleen C." last="Horst">Kathleen C. Horst</name><name sortKey="Macdonald, Shannon M" sort="Macdonald, Shannon M" uniqKey="Macdonald S" first="Shannon M." last="Macdonald">Shannon M. Macdonald</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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