Unresected screen-detected ductal carcinoma in situ: Outcomes of 311 women in the Forget-Me-Not 2 study
This cohort study aimed to determine the outcomes of women who had no surgery for screen-detected DCIS. English breast screening databases were utilised to identify patients diagnosed with DCIS without invasive cancer at screening with no record of surgery within 6 months of diagnosis. Data was available for 311 patients (median age 62 years). 60 patients subsequently developed invasive cancer (56 ipsilateral and 4 contralateral). The ipsilateral invasive cancer risk increased linearly with time. The 10-year cumulative risk of ipsilateral invasive breast cancer was 9%, 39%, and 36% for low, intermediate, and high grade DCIS respectively. Other associated factors that increased this cumulative risk included younger age, larger DCIS lesions, and associated microinvasion. Most subsequent invasive cancers that developed were grade 2 or 3. Therefore, active surveillance may be reasonable alternative to surgery in patients with low grade DCIS. However, patients with intermediate or high grade DCIS should be offered surgery. The study highlights the importance of reproducible DCIS grading to guide patient management.
National Library of Medicine
Classifications: Breast Cancer Treatment
