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International Journal of Surgical Oncology
Volume 2015, Article ID 192579, 4 pages
Research Article

Now, Later of Never: Multicenter Randomized Controlled Trial Call—Is Surgery Necessary after Atypical Breast Core Biopsy Results in Mammographic Screening Settings?

The University of British Columbia, Vancouver, Canada V62 1Y6

Received 14 October 2014; Accepted 21 March 2015

Academic Editor: C. H. Yip

Copyright © 2015 Nikita Makretsov. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Breast cancer mammographic screening leads to detection of premalignant and preinvasive lesions with an increasing frequency. Nevertheless, current epidemiologic evidence indicates that the screening reduces breast cancer specific mortality, but not overall mortality in breast cancer patients. The evidence is lacking whether aggressive eradication of DCIS (preinvasive form of breast carcinoma) by surgery and radiation is of survival benefit, as long-term breast cancer specific mortality in a cohort of patients with DCIS is already in a single digit percent range. Furthermore, it is currently not known whether the aggressive surgical eradication of atypical breast lesions which fall short of diagnosis of DCIS is of any benefit for the patients. Here we propose a model for a randomized controlled trial to generate high level evidence and solve this dilemma.