The biology and management of ductal carcinoma in situ of the breast

Ductal carcinoma in situ (DCIS), sometimes referred to as intraductal carcinoma, is generally a nonpalpable lesion of the breast, detected on screening mammography. The incidence of DCIS is closely intertwined with the usage of mammography screening, as most patients who are diagnosed with DCIS are asymptomatic. Hence, the greater usage of screening mammography has led to dramatic increases in detection and incidence rates of DCIS. In the United States, prior to the advent of mammography screening in the late 1970s, DCIS accounted for less than 5% of all breast tumors, but with the widespread use of mammography screening in recent years, it now comprises 20% to 25% of all breast tumors. </p

The role of irradiation in the management of the axilla in early breast cancer patients

The need for axillary radiotherapy in patients with invasive breast cancer (IBC) has been a topic of great debate in the last decade. Management of the axilla has evolved significantly over the past four decades with a trend towards de-escalation of surgical interventions and the aim of reducing morbidity and enhancing QOL without compromising long-term oncology outcomes. This review article will address the role of axillary irradiation with a focus on the omission of completion axillary lymph node dissection in selected patients with sentinel lymph node (SLN) positive early breast cancer (EBC) with reference to current guidelines based on evidence to date