National Institutes of Health State-of-the-Science Conference Statement: Diagnosis and Management of Ductal Carcinoma In Situ September 22-24, 2009

Allegra, Carmen J.; Aberle, Denise R.; Ganschow, Pamela; Hahn, Stephen M.; Lee, Clara N.; Millon‐Underwood, Sandra; Pike, Malcolm C.; Reed, Susan D.; Saftlas, Audrey F.; Scarvalone, Susan; Schwartz, Arnold M.; Slomski, Carol; Yothers, Greg; Zoň, Robin

doi:10.1093/jnci/djp485

Cited by 270 publications

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“…1,2 An estimated 50,000 new cases of DCIS were diagnosed in the United States in 2010 with greater prevalence in white women compared to women of other racial/ethnic groups. 1,3 Over the past decade the incidence of DCIS, stable among white women, has been increasing among black women. 1,3 The prognosis for women with DCIS is excellent; the 5-year survival rate approaches 100%.…”

Section: Introductionmentioning

confidence: 99%

“…1,3 Over the past decade the incidence of DCIS, stable among white women, has been increasing among black women. 1,3 The prognosis for women with DCIS is excellent; the 5-year survival rate approaches 100%. 4 However, among women with DCIS, the risk of a second DCIS is approximately four times greater than the risk of a first DCIS among women in the general population and the risk of an invasive cancer in the same or opposite breast is approximately twice as great and persists at least 5 years or longer.…”

Section: Introductionmentioning

confidence: 99%

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Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

et al. 2011

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BACKGROUND: As ductal carcinoma in situ (DCIS) is a risk factor for invasive breast cancer, ongoing annual mammography is important for cancer control, yet little is known about racial/ethnic and other disparities in use among older women with DCIS. METHODS: SEER-Medicare data was used to identify women age 65-85 years, diagnosed with DCIS from 1992 to 2005 and treated with surgery, but not bilateral mastectomy. We examined factors associated with receipt of an initial mammogram within 1 year of treatment and subsequent annual mammograms for 3 and 5 years. We examined whether follow-up care, by a primary care physician or cancer specialist, or neighborhood characteristics mediated disparities in mammography use. RESULTS: Overall, 91.3% of women had an initial mammogram. After adjustment, blacks and Hispanics were less likely than whites to receive an initial mammogram (odds ratio (OR) 0.74, 95% confidence interval (CI) 0.55-0.99 and OR 0.65, CI 0.46-0.93, respectively, as were women of lower socioeconomic status (SES), women who had a mastectomy or breast conserving surgery without radiation therapy, and women who did not have a physician visit. Overall rates of annual mammography decreased over time. Disparities by SES, initial treatment type, and physician visit did not diminish over time. Physician visits had a modest effect on reducing initial racial/ethnic disparities. CONCLUSIONS: Annual mammography among women age 65 to 85 with DCIS declines as women get further from diagnosis. Interventions should focus on reducing disparities in the use of initial surveillance mammography, and increasing surveillance over time.KEY WORDS: ductal carcinoma in situ (breast); mammography; disparities.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

et al. 2011

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“…(7) It was found the mean size of DCIS of 1.4 to 2.7 cm, (4) 3.5 cm (8) and 3.7 cm (9) (measured pathologically), 1 to 1.5cm (10) and 2.56 cm. (11) Our study reports a tumor which size is greater than two times of the majority of the descriptions.…”

Section: Discussionmentioning

confidence: 99%

“…(1) The main cancer to affect Brazilian women is non-melanoma skin cancer (71.000 new cases), followed in order of frequency by malignant neoplasms of the breast (53.000), cervix uteri (18.000), colon/rectum (16.000) and lung (10.000). (1) Clinical presentation of pure Ductal Carcinoma in Situ (DCIS) is often described as extension small tumors (4)(5)(6)(7)(8)(9)(10)(11) detected mainly by mammography. Recognizing this type of tumor may manifest as palpable lesion, it is necessary to know and to apply methods that allow diagnosis early: self-breast examination, and clinical examination by a trained team.…”

Section: Introductionmentioning

confidence: 99%

Ductal Carcinoma in Situ of the Breast: A Case Report With an Atypical Clinical Presentation

Campodonio

Oliveira

Machado

2013

BJMHH

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Ductal carcinoma in situ (DCIS) of the breast is a proliferative lesion, precursor of cancer, which has been increasingly diagnosed due to mammographic screening. Tumor size itself does not determine whether the lesion is in situ or invasive, so it is essential to emphasize that DCIS can present with variable extension. We report a case of a 44-year-old female patient that was diagnosed a great (12 cm) DCIS of the breast without microinvasion through pathologic examination. The patient presented with an increase of the right breast, acyclic mastalgia and right bloody nipple discharge. Mammography was inconclusive, the ultrasound suggested inflammation and the incisional biopsy revealed DCIS nuclear grade 3 with compromised lateral margins. It was performed simple mastectomy and axillary node sampling. The clinical presentations of benign and malignant diseases of the breast are variable. The most common symptoms reported by women are pain, palpable mass or nipple discharge. The literature reveals that the extent of this type of cancer is variable, being found in a review intraductal lesions up to 5.4 cm, size smaller than that one that was found in this patient. This finding makes the clinical apresentation interesting to be discussed. Although mammography is the most efficient method to diagnose this injury, clinical breast exam should be performed in all gynecological independent of patient age because it is useful for diagnosing early lesion, considering that it is a palpable lesion.Keywords: Breast cancer; Clinical presentation; Diagnosis. INTRODUCTIONBreast cancer is a common disease among women and in recent decades, has been noticing an increase in incidence and mortality associated with this neoplasm. (1,2,3) According to the Ministry of Health (2012), (1) even being considered as a good prognosis cancer when diagnosed and treated appropriately, mortality from breast cancer still present with high rates in Brazil, probably by the diagnosis in advanced stages (III or IV). The DCIS of the breast involves a heterogeneous group of neoplastic proliferation, non-invasive, with risk of recurrence and malignant transformation. (16) According to Boff and Wisintainer (2006), (17) the increase in the incidence of DCIS is due to mammographic imaging technology that is diagnosing non-palpable breast lesions. They claim that the diagnosis and treatment of non-invasive breast cancer will reduce the mortality rate in up to 46%. In patients adequately treated, the survival rate in 16 years is 95%. (18) DCIS does not invade the lymphatics and blood vessels, therefore, can not spread. It is composed of a population of malignant cells confined to the ducts by the basement membrane. It is therefore a clonal proliferation involving, in general, a single ductal system and the myoepithelial cells are preserved. (19,20) But, may be involved more than one duct or a single duct with more than one target area, separated by parenchyma without lesions. (21) This work aimed to report a case of DCIS of the breast in extensive...

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“…1 The neoplasm is confined to the milk ducts of the breast, and by definition (in situ) is nonmetastatic and noninvasive. Most DCIS lesions are asymptomatic and nonpalpable; they can be detected only by screening mammography, 2 where they appear as microcalcifications.…”

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confidence: 99%

Regression of Ductal Carcinoma In Situ After Treatment with Acupuncture

Dehen

2013

The Journal of Alternative and Complementary Medicine

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This report describes a case of ductal carcinoma in situ (DCIS) that regressed after treatment with acupuncture, Chinese herbs, and other complementary and alternative medicine (CAM). The natural history of DCIS remains to be elucidated, and it is unclear whether all DCIS cases progress to invasive breast cancer. Surgery plus radiation therapy or mastectomy is recommended for women in whom this potentially nonprogressive cancer is detected. This case supports the developing trend toward active surveillance in lieu of breast-disfiguring surgery and offers evidence that CAM therapies may be of value in preventing progression of DCIS to invasive breast cancer.

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National Institutes of Health State-of-the-Science Conference Statement: Diagnosis and Management of Ductal Carcinoma In Situ September 22-24, 2009

Cited by 270 publications

References 0 publications

Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

Use of Annual Mammography Among Older Women with Ductal Carcinoma In Situ

Ductal Carcinoma in Situ of the Breast: A Case Report With an Atypical Clinical Presentation

Regression of Ductal Carcinoma In Situ After Treatment with Acupuncture

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