Clinical risk stratification framework for DCIS
| Risk category | Defining features | Recommended management approach |
|---|---|---|
| Low risk | Low- to intermediate-grade DCIS, small lesion size, favorable biology, low DCIS score™ | Breast-conserving surgery ± endocrine therapy; consideration of treatment de-escalation within clinical trials |
| Intermediate risk | Discordant clinicopathologic features, intermediate DCIS score™, close but negative margins | Breast-conserving surgery with radiotherapy and/or endocrine therapy; individualized decision-making |
| High risk | High-grade disease, comedo necrosis, extensive disease, high DCIS score™, or suspicion of invasion | Surgery with radiotherapy ± endocrine therapy; sentinel lymph node biopsy when mastectomy is planned or when invasion can not be excluded |