The detection rate of ductal carcinoma in situ (DCIS), an early-stage but potentially invasive type of breast cancer, on mammography increases with age, according to a new study from Germany published in the journal Radiology.
DCIS, a type of breast cancer confined to the milk ducts, is commonly found on mammography. Biopsy samples are examined under a microscope to determine the grade of disease: high-grade, intermediate-grade, or low-grade. All grades can develop into invasive disease; however, high-grade DCIS tends to develop faster and becomes a more aggressive disease.
Treatment involves surgery and radiation. But treating DCIS is controversial in that some screening-detected DCIS may never progress to invasive carcinoma in the patient’s remaining lifetime. In addition, DCIS treatment incurs significant costs and risk for potential complications for patients.
For this retrospective study involving 733,905 women age 50 to 69 years, the researchers divided the women in to 5-year age groups.
All the women were participating in a screening program for the first time. Of the participants, 989 (1.35%) women had a graded DCIS diagnosis. Broken down into grades, the 989 cases were 419 with high-grade DCIS, 388 with intermediate-grade DCIS, and 182 with low-grade DCIS.
“The detection rate of high-grade DCIS in our collective showed a statistically significant increase with age, with a maximum rate at the oldest assessed age group of 65 to 69 years,” reported Stefanie Weigel, MD, from the University Hospital Muenster in Muenster, Germany, lead author of the study.
The findings suggest more research is needed on the effectiveness of standard treatment for DCIS, especially among women older than 60 years. Weigel points out that treatment decisions must consider the possibility of overdiagnosis against the evidence that recurrence and progression to invasive carcinoma are more likely in high-grade DCIS.
1. Radiological Society of North America. High-grade DCIS detection rates increase in older women [press release]. EurekAlert Web site. http://www.eurekalert.org/pub_releases/2015-10/rson-hdd101915.php. Accessed October 27, 2015.