Overdiagnosis and overtreatment of breast cancer: Rates of ductal carcinoma in situ: a US perspective

University of California, 1600 Divisadero Street, San Francisco, CA 94115, USA.
Breast cancer research: BCR (Impact Factor: 5.49). 02/2005; 7(6):271-5. DOI: 10.1186/bcr1346
Source: PubMed


The incidence of breast ductal carcinoma in situ (DCIS) in the USA exceeds that of other countries. This cannot be explained entirely by the frequency of mammographic screening in the USA and may result from differences in the interpretation of mammograms and/or the frequency with which biopsies are obtained. Although the percentage of DCIS patients treated with mastectomy has decreased, the absolute number is unchanged and the use of lumpectomy with whole-breast radiotherapy has increased in inverse proportion to the decrease in mastectomy. Treatment of DCIS with tamoxifen is still limited.

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    • "Re-operation is itself associated with further increased risk of subsequent local recurrence [4]. In addition to the problem of identifying additional therapeutic targets in these recurrent cases of DCIS, there is also the issue of over-treatment in the majority of DCIS cases that would remain indolent in the absence of surgery and radiation [5], [6]. Another challenge that DCIS presents is the heterogeneity of the lesions [7], [8]. "
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