Results of 23,810 Cases of Ductal Carcinoma-in-situ

Sumner, William E.; Koniaris, Leonidas G.; Snell, Sarah E.; Spector, Seth A.; Powell, J.; Avisar, Eli; Moffat, Frederick L.; Livingstone, Alan S.; Franceschi, Dido

doi:10.1245/s10434-006-9316-1

Cited by 53 publications

(40 citation statements)

References 27 publications

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“…High-grade DCIS shows abnormal mammography features more frequently than does lowgrade DCIS, because of more obvious calcification. We observed an increase in poorly differentiated DCIS (Figure 2) that may reflect increased use of mammography and also could represent a downstaging from invasive to in situ cancers, as hypothesised (Sumner et al, 2007). We found an increasing trend of well/ moderately differentiated invasive cases, accompanied by a decrease in high-grade cancers, that could be associated with early detection (Tabar et al, 1999;Schopper and de Wolf, 2007).…”

Section: Discussionsupporting

confidence: 64%

Assessment of breast cancer opportunistic screening by clinical–pathological indicators: a population-based study

Bordoni¹,

Probst‐Hensch

Mazzucchelli³

et al. 2009

Br J Cancer

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BACKGROUND: Although some clinical -pathological features of breast cancers, such as the incidence of ductal cancer in situ (DCIS) and the diameter of invasive tumours, are sensitive indicators of early detection, comprehensive population-based studies of opportunistic screening are needed. METHODS: Cases of DCIS or invasive breast cancer diagnosed in 1996 -2007 were identified from the Ticino Cancer Registry (south of Switzerland). Time trends of age-adjusted incidence and mortality, as well as main clinical -pathological features, such as tumour diameter, AJCC stage and histological grade, were analysed. RESULTS: A total of 3047 incident cases of female breast cancer were identified. The proportion of DCIS with respect to invasive cases increased from 5.8% in the period

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Section: Discussionsupporting

confidence: 64%

Assessment of breast cancer opportunistic screening by clinical–pathological indicators: a population-based study

Bordoni¹,

Probst‐Hensch

Mazzucchelli³

et al. 2009

Br J Cancer

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“…However, many women forgo this treatment option due to concerns regarding side effects and the perception of small benefit. Accurate populationbased data regarding prevalence of tamoxifen use for DCIS are limited, but one study suggests that only 14% of patients diagnosed with DCIS are treated with adjuvant hormonal therapy (36). A single institution study reported that of 277 women with DCIS eligible for tamoxifen treatment, only 166 (60%) were offered tamoxifen, and of those, 74 (27%) elected to pursue this therapy.…”

Section: Discussionmentioning

confidence: 99%

Association between Breast Density and Subsequent Breast Cancer Following Treatment for Ductal Carcinoma In situ

Hwang

Miglioretti

Ballard‐Barbash

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Risk of invasive cancer following treatment for ductal carcinoma in situ (DCIS) is associated with both treatment-and tumor-related factors. However, it is unknown whether stromal factors such as breast density may also influence subsequent invasive breast events. We investigated whether breast density is an independent predictor of subsequent breast events among women treated for DCIS. Population: A prospective cohort study of 3,274 women ages 30 to 93 in the Breast Cancer Surveillance Consortium treated with lumpectomy for DCIS between 1993 and 2005. All subjects had an American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) breast density measure recorded prior to diagnosis. Methods: Ipsilateral and contralateral breast cancer following lumpectomy for DCIS were ascertained through state tumor registries, regional Surveillance Epidemiology and End Results program or pathology

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“…Axillary lymph node dissection has declined from 34% of cases undergoing dissection in 1992 to 11% in 2002 (27,28). Approximately 13%-19% of women who undergo lumpectomy are receiving adjuvant hormonal therapy (29,30). An increasing rate of contralateral prophylactic mastectomy from 6.4% in 1998 to 18.4% in 2005 has been reported among women who underwent mastectomy to treat DCIS (31).…”

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confidence: 99%

Epidemiology of Ductal Carcinoma In Situ

2010

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The widespread adoption of screening mammography over the past decade has led to an epidemic of diagnoses of ductal carcinoma in situ (DCIS) of the breast. Because it is rarely clinically palpable or symptomatic, DCIS was rarely diagnosed before the advent of modern mammography (1). DCIS now accounts for about 20%-25% of all newly diagnosed cases of breast cancer in the United States and from 17% to 34% of mammography-detected cases (2-4). Approximately one in every 1300 mammography examinations performed will lead to a diagnosis of DCIS, and it is estimated that 62 280 cases of DCIS will be diagnosed in 2009 (2,5).Data from the Surveillance, Epidemiology, and End Results program depict about a 500% increase in DCIS among women aged 50 years and older from 1983 to 2003 with incidence of DCIS starting to decline in 2003 (6-8) (Figure 1), possibly because of the decline in use of postmenopausal hormone therapy (9). Among women younger than 50 years, there has been a 290% increase in DCIS since 1983 and incidence continues to rise (Figure 1) (6). Incidence of non-comedo DCIS, a type of DCIS not associated with subsequent DCIS or invasive cancer, has generally increased across all age groups, whereas rates of comedo DCIS, a type of DCIS associated with subsequent DCIS or invasive cancer, has held constant or decreased (8). Notably, despite 20 years of detecting DCIS on mammography, a decline in invasive cancer in the United States had not been observed until after the recent large decline in postmenopausal hormone therapy (9).Other than undergoing mammography, older age is one of the strongest risk factors for being diagnosed with DCIS. The rate of DCIS increases with age from 0.6 per 1000 screening examinations in women aged 40-49 years to 1.3 per 1000 screening examinations in women aged 70-84 years (2,10). Population-based incidence and screening rates of DCIS have been found to be similar among white, African American, and Asian/Pacific Islanders (6,11,12). That the rate of DCIS is comparable among women of different ethnicities with a range of invasive cancer rates suggests the incidence of invasive cancer is not directly related to the incidence of DCIS.Risk factors for DCIS and invasive breast cancer are similar suggesting a common etiology for both diseases. However, in many instances, the association of a given characteristic is more strongly associated with invasive cancer than DCIS. Family history of a first-degree relative with breast cancer, nulliparity or late age at first birth, history of biopsy, late age at menopause, long-term use of postmenopausal estrogen and a progestin therapy, and elevated body mass index in postmenopausal women not taking hormone therapy increase the risk of DCIS and invasive cancer (13)(14)(15)(16)(17)(18)(19)(20). High mammographic breast density, one of the strongest risk factors for invasive breast cancer, also has been associated with an increased risk of DCIS (15,16,21). Smoking, lactation, early menarche, increased alcohol consumption, and oral contraceptive use eith...

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Results of 23,810 Cases of Ductal Carcinoma-in-situ

Cited by 53 publications

References 27 publications

Assessment of breast cancer opportunistic screening by clinical–pathological indicators: a population-based study

Assessment of breast cancer opportunistic screening by clinical–pathological indicators: a population-based study

Association between Breast Density and Subsequent Breast Cancer Following Treatment for Ductal Carcinoma In situ

Epidemiology of Ductal Carcinoma In Situ

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