文章：

学习区分进展性和非进展性导管原位癌

Learning to distinguish progressive and non-progressive ductal carcinoma in situ

原文发布日期：2022-10-19

DOI: 10.1038/s41568-022-00512-y

类型: Review Article

开放获取: 否

英文摘要：

Ductal carcinoma in situ (DCIS) is a non-invasive breast neoplasia that accounts for 25% of all screen-detected breast cancers diagnosed annually. Neoplastic cells in DCIS are confined to the ductal system of the breast, although they can escape and progress to invasive breast cancer in a subset of patients. A key concern of DCIS is overtreatment, as most patients screened for DCIS and in whom DCIS is diagnosed will not go on to exhibit symptoms or die of breast cancer, even if left untreated. However, differentiating low-risk, indolent DCIS from potentially progressive DCIS remains challenging. In this Review, we summarize our current knowledge of DCIS and explore open questions about the basic biology of DCIS, including those regarding how genomic events in neoplastic cells and the surrounding microenvironment contribute to the progression of DCIS to invasive breast cancer. Further, we discuss what information will be needed to prevent overtreatment of indolent DCIS lesions without compromising adequate treatment for high-risk patients.

摘要翻译： 

导管原位癌（DCIS）是一种非浸润性乳腺肿瘤，占每年筛查确诊乳腺癌总数的25%。尽管导管原位癌的肿瘤细胞局限于乳腺导管系统，但部分患者的癌细胞可能突破基底膜进展为浸润性乳腺癌。导管原位癌的核心诊疗难点在于过度治疗——即使未经治疗，大多数筛查确诊的患者并不会出现临床症状或死于乳腺癌。然而，如何区分低风险惰性导管原位癌与潜在进展性病变仍是临床面临的挑战。本文综述当前对导管原位癌的认知，探讨关于其基础生物学的未解之谜，包括肿瘤细胞基因组事件与肿瘤微环境如何共同促进导管原位癌向浸润性乳腺癌进展。此外，我们还将讨论如何在不影响高危患者适当治疗的前提下，避免对惰性导管原位癌病变的过度治疗所需的关键信息。

原文链接：

Learning to distinguish progressive and non-progressive ductal carcinoma in situ