导管内癌（DCIS）管理的演变是由我们对其自然史的理解的演变所推动的。早期试验确定了辅助治疗对所有DCIS患者的益处。相反，随后的研究将患者分层以确定其是否有资格接受日益减轻和不那么强烈的治疗。大规模随机试验和荟萃分析支持了这种转变，远离以相似的强度治疗同质性疾病，而更加关注DCIS的特殊情况。本文回顾了基于当前DCIS管理的里程碑式研究。© 2023. Society of Surgical Oncology.

The evolution of ductal carcinoma in situ (DCIS) management has been driven by a parallel evolution in our understanding of its natural history. Early trials established the benefit of adjuvant therapies in all patients with DCIS. In contrast, subsequent studies have stratified patients to determine their eligibility for progressively less invasive and less intensive therapies. Large, randomized trials and meta-analyses have supported this shift away from treating DCIS as an homogenous disease treated with similar intensity to invasive breast cancer. This review describes the landmark studies on which current DCIS management is based.© 2023. Society of Surgical Oncology.