Document Detail

Changing patterns in diagnosis and treatment of ductal carcinoma in situ of the breast.
MedLine Citation:
PMID:  15923104     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The increased incidence of ductal carcinoma in situ (DCIS) of the breast and the emergence of new diagnostic and therapeutic tools like mammographic screening, stereotactic core biopsy and reconstructive surgery prompted us to investigate how these developments influenced diagnosis and treatment. METHODS: Clinical and pathological characteristics of 403 patients with DCIS consecutively treated at The Netherlands Cancer Institute between 1986 and 2002 were evaluated and the effect of introduction of mammographic screening, stereotactic core biopsy and reconstruction on diagnosis and treatment was studied. RESULTS: Following the nationwide introduction of mammographic screening the number of non-symptomatic DCIS increased from 47 to 77%. Introduction of stereotactic core biopsy resulted in a rise of one-step procedures from 26 to 52%. Mastectomy rate did not change over time: 59% overall. However, reconstruction rate increased from 17 to 39%. CONCLUSION: This study shows a steep rise in diagnosis of non-symptomatic DCIS after introduction of screening. Further, the introduction of pre-operative diagnosis by stereotactic core biopsy resulted in a decrease of multiple surgical procedures. Mastectomy, with increasing application of breast reconstructions, remains an important treatment modality in the management of DCIS despite advancements in detection and diagnosis.
Ph Meijnen; J L Peterse; H S A Oldenburg; L A E Woerdeman; E J Th Rutgers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology     Volume:  31     ISSN:  0748-7983     ISO Abbreviation:  Eur J Surg Oncol     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-27     Completed Date:  2005-11-10     Revised Date:  2007-07-02    
Medline Journal Info:
Nlm Unique ID:  8504356     Medline TA:  Eur J Surg Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  833-9     Citation Subset:  IM    
Department of Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
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MeSH Terms
Aged, 80 and over
Biopsy / methods,  statistics & numerical data
Breast Neoplasms / diagnosis*,  therapy
Carcinoma in Situ / diagnosis*,  therapy
Carcinoma, Ductal, Breast / diagnosis*,  therapy
Mammaplasty / statistics & numerical data
Mammography / statistics & numerical data
Mass Screening / statistics & numerical data
Mastectomy / statistics & numerical data
Mastectomy, Segmental / statistics & numerical data
Middle Aged
Reconstructive Surgical Procedures / statistics & numerical data
Retrospective Studies
Stereotaxic Techniques / statistics & numerical data

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