International variation in management of screen-detected ductal carcinoma in situ of the breast.

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Serval ID
serval:BIB_65574364A4C6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
International variation in management of screen-detected ductal carcinoma in situ of the breast.
Journal
European Journal of Cancer
Author(s)
Ponti A., Lynge E., James T., Májek O., von Euler-Chelpin M., Anttila A., Fitzpatrick P., Mano M.P., Kawai M., Scharpantgen A., Fracheboud J., Hofvind S., Vidal C., Ascunce N., Salas D., Bulliard J.L., Segnan N., Kerlikowske K., Taplin S.
Working group(s)
ICSN DCIS Working group
ISSN
1879-0852 (Electronic)
ISSN-L
0959-8049
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
50
Number
15
Pages
2695-2704
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
BACKGROUND: Ductal carcinoma in situ (DCIS) incidence has grown with the implementation of screening and its detection varies across International Cancer Screening Network (ICSN) countries. The aim of this survey is to describe the management of screen-detected DCIS in ICSN countries and to evaluate the potential for treatment related morbidity.
METHODS: We sought screen-detected DCIS data from the ICSN countries identified during 2004-2008. We adopted standardised data collection forms and analysis and explored DCIS diagnosis and treatment processes ranging from pre-operative diagnosis to type of surgery and radiotherapy.
RESULTS: Twelve countries contributed data from a total of 15 screening programmes, all from Europe except the United States of America and Japan. Among women aged 50-69years, 7,176,050 screening tests and 5324 screen-detected DCIS were reported. From 21% to 93% of DCIS had a pre-operative diagnosis (PO); 67-90% of DCIS received breast conservation surgery (BCS), and in 41-100% of the cases this was followed by radiotherapy; 6.4-59% received sentinel lymph node biopsy (SLNB) only and 0.8-49% axillary dissection (ALND) with 0.6% (range by programmes 0-8.1%) being node positive. Among BCS patients 35% received SLNB only and 4.8% received ALND. Starting in 2006, PO and SLNB use increased while ALND remained stable. SLNB and ALND were associated with larger size and higher grade DCIS lesions.
CONCLUSIONS: Variation in DCIS management among screened women is wide and includes lymph node surgery beyond what is currently recommended. This indicates the presence of varying levels of overtreatment and the potential for its reduction.
Pubmed
Web of science
Open Access
Yes
Create date
30/10/2014 17:24
Last modification date
20/08/2019 14:21
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