Management of noninvasive breast cancer

DCIS and LCIS are rarely symptomatic although extensive preinvasive disease may present with a mass or thickening of breast tissue.

Treatment options

♦ Simple mastectomy 95% cure rate

Rarely relapse, due to micro-invasive cancer No need for axillary dissection

♦ Wide excision alone—30% recurrence at 5 years

♦ Wide excision + radiotherapy—15% recurrence at 5 years

The management of LCIS is controversial; Bilateral breast excision of LCIS should be followed by close surveillance. Few surgeons would instead advocate bilateral subcutaneous mastectomies and immediate reconstruction.

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