本文由小咖机器人翻译整理

期刊来源：Lancet

原文链接：https://doi.org/10.1016/S0140-6736(24)00425-2

摘要内容如下：

导管原位癌（DCIS）占所有乳腺癌诊断的15-25%。其总体预后良好，主要风险是局部乳腺事件的发生，因为大多数DCIS病例不会进展为浸润性癌。系统筛查大大增加了这种非侵袭性先兆的发生率，迫切需要识别易发生侵袭性进展的DCIS，并将其与非侵袭性DCIS区分开来，因为后者可能被过度诊断并因此被过度治疗。治疗策略，包括手术、放疗和选择性内分泌治疗，可降低局部事件的风险，但对生存结果没有影响。主动监测正在被评估为低风险DCIS的一种可能的新选择。为破译DCIS的生物学所做的大量努力使我们对决定其可变自然史的因素有了更好的了解。鉴于这种可变性，关于最佳个性化治疗策略的共同决策是最合适的行动方案。设计良好、基于风险的降级研究仍然是该领域的主要需求。

英文原文如下：

Abstracts

Ductal carcinoma in situ (DCIS) accounts for 15-25% of all breast cancer diagnoses. Its prognosis is excellent overall, the main risk being the occurrence of local breast events, as most cases of DCIS do not progress to invasive cancer. Systematic screening has greatly increased the incidence of this non-obligate precursor of invasion, lending urgency to the need to identify DCIS that is prone to invasive progression and distinguish it from non-invasion-prone DCIS, as the latter can be overdiagnosed and therefore overtreated. Treatment strategies, including surgery, radiotherapy, and optional endocrine therapy, decrease the risk of local events, but have no effect on survival outcomes. Active surveillance is being evaluated as a possible new option for low-risk DCIS. Considerable efforts to decipher the biology of DCIS have led to a better understanding of the factors that determine its variable natural history. Given this variability, shared decision making regarding optimal, personalised treatment strategies is the most appropriate course of action. Well designed, risk-based de-escalation studies remain a major need in this field.

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