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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2011

01-08-2011 | Epidemiology

Characterizing the impact of 25 years of DCIS treatment

Authors: Elissa M. Ozanne, Yiwey Shieh, James Barnes, Colleen Bouzan, E. Shelley Hwang, Laura J. Esserman

Published in: Breast Cancer Research and Treatment | Issue 1/2011

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Abstract

The significant increase in the detection and treatment of ductal carcinoma in situ (DCIS) since the introduction of screening mammography has not been accompanied by the anticipated reduction in invasive breast cancer (IBC) incidence. The prevalence of DCIS requires a reexamination of the population level effects of detecting and treating DCIS. To further our understanding of the possible impact of DCIS diagnosis and treatment on IBC incidence in the U.S., we simulated breast cancer incidence over 25 years under various assumptions regarding the baseline incidence of IBC and the progression of DCIS to IBC. The simulations demonstrate a tradeoff between the expected increased incidence of IBC absent any DCIS detection and treatment and the rate of progression of DCIS to IBC. Our analyses indicate that a high progression of DCIS to IBC implies a significant increase in incidence of IBC over what is observed had we not detected and treated DCIS. Conversely, if we assume that there would not have been a significant increase over and above the observed incidence evident in SEER, then our model indicates that the rate of DCIS progression to clinically significant IBC is low. Given the tradeoff illustrated by our model, we must reevaluate the assumption that DCIS is a short-term obligate precursor of invasive cancer and instead focus on further exploration of the true natural history of DCIS.
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Metadata
Title
Characterizing the impact of 25 years of DCIS treatment
Authors
Elissa M. Ozanne
Yiwey Shieh
James Barnes
Colleen Bouzan
E. Shelley Hwang
Laura J. Esserman
Publication date
01-08-2011
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2011
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-011-1430-5

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