1. The management of patients with ductal carcinoma in situ (DCIS) of the breast has become a major clinical dilemma owing to the recent trend toward breast preservation. DCIS represents a heterogeneous group with histologic and clinical differences; therefore, predictors of recurrence are well worth investigating in each single woman. Complete excision, based on specimen radiological/mammographic correlation, and microscopic evaluation of resection margins are important determinants of local control. Determination of high risk factors [i.e. increased tumour size, high nuclear grade, presence of comedo-type necrosis as well as pair periductal fibrosis and clinical tumour detection (when taken together)] is important in predicting local failure.
2. As concerns ductal invasive breast cancer, the prognostic value of classic clinicopathologic indicators remains irreplaceable. Mitotic frequency counting adds prognostic information to tumour size and influences length of patients survival in groups of T₁N₀,T₁N₁ and T₂N₀ tumours. The combination of poor nuclear grade and lymphatic vessel invasion identifies a subset of patients with T₁a,b N₀M₀ breast cancer with a significant relapse risk that warrants consideration of adjuvant systemic therapy. The predictive value of the presence of effective oestrogen and progesterone receptors in node negative tumours is associated with a favourable disease -free and overall survival difference; however, this advantage is being eroded by the early appearance of other factors such as increased proliferative capacity and overexpression of c-erbB-2 oncoprotein with simultaneous mutant p53 overexpression.

Key words: Ductal invasive breast cancer, prognostic markers.

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