Screen-detected ductal carcinoma in situ, 2008–2020: An observational study

Author:

Kelly Caitriona12ORCID,Fitzpatrick Patricia13ORCID,Quinn Cecily4,Flanagan Fidelma4,Connors Alissa4,Larke Aideen4,Mooney Therese3,Kennedy Maria4,Sheehan Margaret4,Bennett Michael W.35,Brodie Caroline46,O’Doherty Ann4

Affiliation:

1. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland

2. Department of Public Health HSE North East, Navan, Ireland

3. National Screening Service, Dublin, Ireland

4. BreastCheck, National Screening Service, Dublin, Ireland

5. Department of Pathology, Cork University Hospital, Cork, Ireland

6. Department of Anatomic Pathology, Galway University Hospital and National University of Ireland, Galway, Ireland

Abstract

Objectives The purpose of this study was to evaluate the grade distribution of screen-detected ductal carcinoma in situ (DCIS) diagnosed in Ireland, in the context of the clinical trials currently underway to determine if active surveillance is a feasible management option for low-risk DCIS. Setting BreastCheck is the national breast screening programme in Ireland, offering screening to women aged 50 to 69 every two years. Methods This study was a secondary analysis of data collected by BreastCheck on all screen-detected DCIS diagnosed in the 12 years of nationwide screening. Incidence and detection rates were calculated. Descriptive analysis of the cases was performed and, for comparative analysis, grade of DCIS was analysed as a binary variable (high vs. low/intermediate) in keeping with the inclusion criteria for active surveillance trials. Analysis was performed in IBM Statistical Package for Social Sciences, version 26. Results Between 2008 and 2020, 2240 women were diagnosed with DCIS through BreastCheck; 876 (39.1%) were low/intermediate-grade. The overall incidence rate has remained relatively stable during this period. Women with low/intermediate-grade DCIS were younger than women with high-grade DCIS (56 (interquartile range: 56-61) years v 57 (interquartile range: 53–61) years; p < 0.001). They were also more likely to have been diagnosed at an initial screening episode compared with those who had high-grade lesions (42.5% v 29.0%; p < 0.001). Conclusion If current clinical trials recommend active surveillance as a feasible option for DCIS, up to 40% of women with screen-detected DCIS may be eligible. These women are younger and often diagnosed on initial screening episode, so may require longer active follow-up.

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Health Policy

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