目前导管原位癌（DCIS）的治疗标准是手术加或不加辅助放疗。随着关于低风险导管原位癌过度诊断和过度治疗的争论日益激烈，多项正在进行的试验正在探索主动监测。我们进行了系统回顾和荟萃分析，以评估不同治疗方法下低风险 DCIS 的复发情况。检索了 PubMed、Embase、Web of Science 和 Cochrane 报告同侧乳腺肿瘤事件 (IBTE)、对侧乳腺癌（ CBC）以及低风险 DCIS 中 5 年和 10 年的乳腺癌特异性生存率 (BCSS)。主要结果是侵入性 IBTE (iIBTE)，定义为同侧乳房的侵入性进展。确定了 33 项符合条件的研究，涉及 47,696 名患有低风险 DCIS 的女性。汇总的 5 年和 10 年 iIBTE 率分别为 3.3%（95% 置信区间 [CI]：1.3、8.1）和 5.9%（95% CI：3.8、9.0）。与未接受手术的患者相比，接受手术的患者在 5 年（3.5% vs. 9.0%，P = 0.003）和 10 年（6.4% vs. 22.7%，P = 0.008）时的 iIBTE 率显着降低。同样，手术组的 10 年 BCSS 率较高（96.0% vs. 99.6%，P = 0.010）。在接受保乳手术治疗的患者中，额外的放疗显着降低了 IBTE 风险，但没有降低总 CBC 风险。本次综述显示，接受低风险 DCIS 手术和额外放疗的女性的进展风险较低，生存率较高。然而，我们的发现主要基于观察性研究，并应通过正在进行的试验的结果得到证实。© 2024。作者。

The current standard of treatment for ductal carcinoma in situ (DCIS) is surgery with or without adjuvant radiotherapy. With a growing debate about overdiagnosis and overtreatment of low-risk DCIS, active surveillance is being explored in several ongoing trials. We conducted a systematic review and meta-analysis to evaluate the recurrence of low-risk DCIS under various treatment approaches.PubMed, Embase, Web of Science, and Cochrane were searched for studies reporting ipsilateral breast tumour event (IBTE), contralateral breast cancer (CBC), and breast cancer-specific survival (BCSS) rates at 5 and 10 years in low-risk DCIS. The primary outcome was invasive IBTE (iIBTE) defined as invasive progression in the ipsilateral breast.Thirty three eligible studies were identified, involving 47,696 women with low-risk DCIS. The pooled 5-year and 10-year iIBTE rates were 3.3% (95% confidence interval [CI]: 1.3, 8.1) and 5.9% (95% CI: 3.8, 9.0), respectively. The iIBTE rates were significantly lower in patients who underwent surgery compared to those who did not, at 5 years (3.5% vs. 9.0%, P = 0.003) and 10 years (6.4% vs. 22.7%, P = 0.008). Similarly, the 10-year BCSS rate was higher in the surgery group (96.0% vs. 99.6%, P = 0.010). In patients treated with breast-conserving surgery, additional radiotherapy significantly reduced IBTE risk, but not total-CBC risk.This review showed a lower risk of progression and better survival in women who received surgery and additional RT for low-risk DCIS. However, our findings were primarily based on observational studies, and should be confirmed with the results from the ongoing trials.© 2024. The Author(s).