ACR appropriateness criteria ® ductal carcinoma in situ

Meena S. Moran, Harrison X. Bai, Eleanor E R Harris, Douglas W. Arthur, Lisa Bailey, Jennifer R. Bellon, Lisa Carey, Sharad Goyal, Michele Y. Halyard, Kathleen C. Horst, Shannon M. MacDonald, Bruce G. Haffty

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Ductal carcinoma in situ (DCIS) describes a wide spectrum of non-invasive tumors which carry a significant risk of invasive relapse, thus prevention of local recurrence is vital. For appropriate patients with limited disease, management with breast conserving surgery (BCS) followed by whole-breast radiation (RT) is supported by multiple Phase III studies, but mastectomy may be appropriate in selected patients. Omission of RT may also be reasonable in some patients, though which criteria are to be utilized remain unclear, and the existing data are contradictory with limited follow-up. Various RT techniques such as boost to the tumor bed, partial breast radiation or hypofractionated, whole-breast RT are increasingly utilized but the data to support their use specifically in DCIS is limited. Tamoxifen also increases local control for ER + DCIS, adding to the complexity of the local treatment management. This article reviews the existing scientific evidence, the controversies surrounding local management, and clinical guidelines for DCIS based on the group consensus by the ACR Breast Expert Panel. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)8-15
Number of pages8
JournalBreast Journal
Volume18
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Carcinoma, Intraductal, Noninfiltrating
Radiation
Breast
Guidelines
Segmental Mastectomy
Mastectomy
Expert Testimony
Tamoxifen
Disease Management
Secondary Prevention
Radiology
Neoplasms
Therapeutics
Recurrence

Keywords

  • ACR appropriateness criteria
  • breast conservation therapy
  • ductal carcinoma in situ
  • guidelines
  • radiation therapy

ASJC Scopus subject areas

  • Internal Medicine
  • Oncology
  • Surgery

Cite this

Moran, M. S., Bai, H. X., Harris, E. E. R., Arthur, D. W., Bailey, L., Bellon, J. R., ... Haffty, B. G. (2012). ACR appropriateness criteria ® ductal carcinoma in situ. Breast Journal, 18(1), 8-15. https://doi.org/10.1111/j.1524-4741.2011.01197.x

ACR appropriateness criteria ® ductal carcinoma in situ. / Moran, Meena S.; Bai, Harrison X.; Harris, Eleanor E R; Arthur, Douglas W.; Bailey, Lisa; Bellon, Jennifer R.; Carey, Lisa; Goyal, Sharad; Halyard, Michele Y.; Horst, Kathleen C.; MacDonald, Shannon M.; Haffty, Bruce G.

In: Breast Journal, Vol. 18, No. 1, 01.2012, p. 8-15.

Research output: Contribution to journalArticle

Moran, MS, Bai, HX, Harris, EER, Arthur, DW, Bailey, L, Bellon, JR, Carey, L, Goyal, S, Halyard, MY, Horst, KC, MacDonald, SM & Haffty, BG 2012, 'ACR appropriateness criteria ® ductal carcinoma in situ', Breast Journal, vol. 18, no. 1, pp. 8-15. https://doi.org/10.1111/j.1524-4741.2011.01197.x
Moran MS, Bai HX, Harris EER, Arthur DW, Bailey L, Bellon JR et al. ACR appropriateness criteria ® ductal carcinoma in situ. Breast Journal. 2012 Jan;18(1):8-15. https://doi.org/10.1111/j.1524-4741.2011.01197.x
Moran, Meena S. ; Bai, Harrison X. ; Harris, Eleanor E R ; Arthur, Douglas W. ; Bailey, Lisa ; Bellon, Jennifer R. ; Carey, Lisa ; Goyal, Sharad ; Halyard, Michele Y. ; Horst, Kathleen C. ; MacDonald, Shannon M. ; Haffty, Bruce G. / ACR appropriateness criteria ® ductal carcinoma in situ. In: Breast Journal. 2012 ; Vol. 18, No. 1. pp. 8-15.
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