An Argument Against Routine Use of Radiotherapy for Ductal Carcinoma In Situ
November 1st 2003In his article, Dr. Silverstein reviewsthe changing incidence of ductalcarcinoma in situ (DCIS) in theUnited States over the past 25 years,discusses the results of various clinicaltrials evaluating treatment optionsfor the disease, and, using the VanNuys Prognostic Index (VNPI), identifiesa subgroup of DCIS patientstreated by lumpectomy who, he feels,may be able to avoid breast irradiation.During several presentations atnational meetings, I have had the opportunityto debate Dr. Silverstein onthis topic. He is a powerful and articulateproponent of the idea thatcertain DCIS patients could be exemptedfrom radiation therapy withoutconsequences.