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[Comment] Endocrine treatment for ductal carcinoma in situ: balancing risks and benefits

Up to 20% of all newly diagnosed breast cancers are non-invasive carcinomas, known as ductal carcinoma in situ.1 Surgical excision is the mainstay of management, with the addition of breast irradiation after breast-conserving surgery shown to reduce ipsilateral breast cancer recurrence in five randomised controlled trials.1 Because molecular and epigenetic evidence suggests that ductal carcinoma in situ is a precursor for invasive breast cancer, an important question has been whether systemic adjuvant endocrine therapy can affect the natural history of ductal carcinoma in situ, especially given its role in reducing recurrence and preventing contralateral disease and improving overall survival in patients with oestrogen-receptor (ER) positive invasive breast cancer.