Risk of subsequent invasive breast cancer after a diagnosis of ductal carcinoma in situ (DCIS)

The method of detection of ductal carcinoma in situ has no therapeutic implications: results of a population-based cohort study

“…As a consequence, interpreting the association between method of detection and outcome of treatment of DCIS is more difficult. A few studies have evaluated whether women with DCIS detected through a population-based screening program have better prognosis than women with non-screening-related DCIS [18, 19], and therefore can be compared to our findings. Cheung et al [19] ( n  = 3930 subjects, length of follow up not reported) found that the difference in risk of ipsilateral invasive breast cancer between screen-detected and non-screening-related DCIS was somewhat larger than in our study (annual absolute risk 0.43% vs. 0.65%; HR = 0.32, P value <0.0001), possibly because of variation in selection criteria.…”

“…A few studies have evaluated whether women with DCIS detected through a population-based screening program have better prognosis than women with non-screening-related DCIS [18, 19], and therefore can be compared to our findings. Cheung et al [19] ( n  = 3930 subjects, length of follow up not reported) found that the difference in risk of ipsilateral invasive breast cancer between screen-detected and non-screening-related DCIS was somewhat larger than in our study (annual absolute risk 0.43% vs. 0.65%; HR = 0.32, P value <0.0001), possibly because of variation in selection criteria. Our study only included women who were eligible for participation in the population-based screening program based on age, whereas Cheung et al analyzed all women, and thus also included younger women (<50 years) who have a higher risk of invasive breast cancer compared to older women [33].…”

“…Previous studies suggest that the method of detection may also carry prognostic information in women treated for DCIS [16–19], but it is still unclear whether women with screen-detected DCIS have a clinically relevant better prognosis than women with non-screening-related DCIS and whether the method for detection should be used in the treatment decision-making process, such as the addition or omission of radiotherapy and anti-estrogen treatment. To this end, we studied risk of subsequent ipsilateral and contralateral invasive breast cancer and all-cause mortality among a large population-based cohort of women with screen-detected, interval, and non-screening-related DCIS.…”

Cancer Incidence, Mortality, and Stage at Diagnosis in First Nations Living in Manitoba

“…Women whose first cancer was ductal carcinoma in situ were excluded, because those cancers are surgically removed to prevent progression and possible development of invasive carcinoma 34 . Because only women 50-69 years of age were eligible to participate in the provincial breast screening program during the study period, the analysis was stratified by age group (<50, 50-69, and ≥70 years).…”

Should local treatment of breast ductal carcinoma in situ be the same as the treatment of early invasive breast cancer

“…The basic arguments for the treatment of ductal carcinoma in situ in the same way as early invasive cancer comprise: -unknown natural history of untreated DCIS [16]; -high risk of undervaluation of the invasive component in the core-needle biopsy [10,[16][17][18]; -increase of recurrence risk with the progress of time [3,[19][20][21]; -lack of verified separators of the groups with the risk of adverse course of the disease [1,2,20]; -the results of the clinical studies confirming the justification of combined local treatment [22][23][24][25][26]; -and the proof that the clinical course of DCIS is the same as early invasive breast cancer [27,28]; -the lack of clinical studies which could justify a limitation of the treatment scope [28][29][30]. Given the fact that a large share of ductal carcinoma in situ is diagnosed as a small lesion seen only in a mammography image, and then treated with a mammotomy biopsy, a substantial part of DCIS is resected during this procedure.…”