Ductaal carcinoma in situ: de balans tussen over- en onderbehandeling

• Since population-based breast cancer screening was implemented in the Netherlands, the incidence of Ductal Carcinoma In Situ of the breast, regarded as a non-obligate precursor lesion of breast cancer, has strongly increased.
• However, the incidence of invasive breast cancer has not decreased. This suggests that a percentage of all the DCIS lesions would never have become symptomatic if no screening was performed. This phenomenon is known as ‘overdiagnosis’.
• Nonetheless, almost all DCIS lesions are managed surgically, often followed by radiotherapy in those having breast-conserving treatment, to avoid potential progression to breast cancer.
• To prevent potential over- or undertreatment, further studies are required to distinguish low from high risk DCIS.
• Ultimately this could help avoid non-beneficial intensive treatment for women with low risk DCIS.

Conflict of interest and financial support for this article: J. Wesseling has received research grants from the Dutch Cancer Society, Pink Ribbon Netherlands and A Sister’s Hope.