Re: Trends in the Treatment of Ductal Carcinoma In Situ of the Breast

Extract

Baxter et al. ( 1 ) bring to light a number of issues about the diagnosis and management of ductal carcinoma in situ (DCIS) of the breast. It is interesting that the proportion of comedo histology decreased during the period from 1992 through 1999, that less than 50% of lesions had a reported grade, and that tumor size was not reported in one-third of cases.

The National Breast Cancer Centre (NBCC) in Australia commissioned a population-based study ( 2 ) that reviewed the epidemiology and pathology of DCIS reported to the cancer registry in one large Australian state from 1995 through 2000. The study identified a number of trends in important areas of reporting and management. First, about 65% of all cases over the 6-year period were identified through initial contact with the national population-based screening program, BreastScreen Australia. Second, fewer cases of DCIS were identified with comedo histology from 1998 through 2000 than from 1995 through 1997 (10% versus 26%, respectively). Finally, pathology reports of DCIS from 1998 through 2000 were more complete than earlier reports. For instance, the joint reporting of both size and grade were not recorded in 27% of reports from 1995 through 1997 but had decreased to only 9% of reports from 1998 through 2000.