MANAGEMENT OF IN-SITU AND MINIMALLY INVASIVE BREAST-CARCINOMA

In situ breast carcinoma represents an early localized stage in the tr ansition to invasive breast carcinoma and has an especially favorable prognosis with appropriate management. The widespread use of mammograp hy has contributed to its increased rate of diagnosis. The two histolo gic forms of this entity have distinct pathologic and biologic charact eristics, with different therapeutic implications. Lobular carcinoma i n situ is considered a marker of increased risk for subsequent invasiv e carcinoma and is most commonly managed by nonoperative surveillance. Ductal carcinoma in situ behaves more as a true anatomic precursor of invasive disease and has the same therapeutic options as invasive bre ast carcinoma. Minimally invasive breast carcinoma should be considere d a fundamentally different entity, primarily because of its potential for systemic metastasis that in situ lesions do not theoretically hav e. There are still many outstanding issues and dilemmas to be resolved by scientific investigation before the intriguing potential of these early forms of breast malignancy are fully understood.