| PONTI, Antonio, Elsebeth LYNGE, Ted JAMES, Ondřej MÁJEK, My von EULER-CHELPIN, Ahti ANTTILA, Patricia FITZPATRICK, Maria Piera MANO, Masaaki KAWAI, Astrid SCHARPANTGEN, Jacques FRACHEBOUD, Solveig HOFVIND, Carmen VIDAL, Nieves ASCUNCE, Dolores SALAS, Jean-Luc BULLIARD, Nereo SEGNAN, Karla KERLIKOWSKE a Stephen TAPLIN. International variation in management of screen-detected ductal carcinoma in situ of the breast. European Journal of Cancer. Oxford: Elsevier Science Ltd., roč. 50, č. 15, s. 2695-2704. ISSN 0959-8049. doi:10.1016/j.ejca.2014.07.019. 2014. |
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@article{1209784,
author = {Ponti, Antonio and Lynge, Elsebeth and James, Ted and Májek, Ondřej and EulerandChelpin, My von and Anttila, Ahti and Fitzpatrick, Patricia and Mano, Maria Piera and Kawai, Masaaki and Scharpantgen, Astrid and Fracheboud, Jacques and Hofvind, Solveig and Vidal, Carmen and Ascunce, Nieves and Salas, Dolores and Bulliard, JeanandLuc and Segnan, Nereo and Kerlikowske, Karla and Taplin, Stephen},
article_location = {Oxford},
article_number = {15},
doi = {http://dx.doi.org/10.1016/j.ejca.2014.07.019},
keywords = {Breast cancer; Ductal carcinoma in situ (DCIS); Screening mammography; Overtreatment; Axillary staging; Cancer registration},
language = {eng},
issn = {0959-8049},
journal = {European Journal of Cancer},
title = {International variation in management of screen-detected ductal carcinoma in situ of the breast},
volume = {50},
year = {2014}
}
TY - JOUR
ID - 1209784
AU - Ponti, Antonio - Lynge, Elsebeth - James, Ted - Májek, Ondřej - Euler-Chelpin, My von - Anttila, Ahti - Fitzpatrick, Patricia - Mano, Maria Piera - Kawai, Masaaki - Scharpantgen, Astrid - Fracheboud, Jacques - Hofvind, Solveig - Vidal, Carmen - Ascunce, Nieves - Salas, Dolores - Bulliard, Jean-Luc - Segnan, Nereo - Kerlikowske, Karla - Taplin, Stephen
PY - 2014
TI - International variation in management of screen-detected ductal carcinoma in situ of the breast
JF - European Journal of Cancer
VL - 50
IS - 15
SP - 2695-2704
EP - 2695-2704
PB - Elsevier Science Ltd.
SN - 09598049
KW - Breast cancer
KW - Ductal carcinoma in situ (DCIS)
KW - Screening mammography
KW - Overtreatment
KW - Axillary staging
KW - Cancer registration
N2 - Background: Ductal carcinoma in situ (DCIS) incidence has grown with the implementation of screening and its detection varies across International Cancer Screening Network (ICSN) countries. The aim of this survey is to describe the management of screen-detected DCIS in ICSN countries and to evaluate the potential for treatment related morbidity. Methods: We sought screen-detected DCIS data from the ICSN countries identified during 2004-2008. We adopted standardised data collection forms and analysis and explored DCIS diagnosis and treatment processes ranging from pre-operative diagnosis to type of surgery and radiotherapy. Results: Twelve countries contributed data from a total of 15 screening programmes, all from Europe except the United States of America and Japan. Among women aged 50-69 years, 7,176,050 screening tests and 5324 screen-detected DCIS were reported. From 21% to 93% of DCIS had a pre-operative diagnosis (PO); 67-90% of DCIS received breast conservation surgery (BCS), and in 41-100% of the cases this was followed by radiotherapy; 6.4-59% received sentinel lymph node biopsy (SLNB) only and 0.8-49% axillary dissection (ALND) with 0.6% (range by programmes 0-8.1%) being node positive. Among BCS patients 35% received SLNB only and 4.8% received ALND. Starting in 2006, PO and SLNB use increased while ALND remained stable. SLNB and ALND were associated with larger size and higher grade DCIS lesions. Conclusions: Variation in DCIS management among screened women is wide and includes lymph node surgery beyond what is currently recommended. This indicates the presence of varying levels of overtreatment and the potential for its reduction.
ER -
PONTI, Antonio, Elsebeth LYNGE, Ted JAMES, Ondřej MÁJEK, My von EULER-CHELPIN, Ahti ANTTILA, Patricia FITZPATRICK, Maria Piera MANO, Masaaki KAWAI, Astrid SCHARPANTGEN, Jacques FRACHEBOUD, Solveig HOFVIND, Carmen VIDAL, Nieves ASCUNCE, Dolores SALAS, Jean-Luc BULLIARD, Nereo SEGNAN, Karla KERLIKOWSKE a Stephen TAPLIN. International variation in management of screen-detected ductal carcinoma in situ of the breast. \textit{European Journal of Cancer}. Oxford: Elsevier Science Ltd., roč.~50, č.~15, s.~2695-2704. ISSN~0959-8049. doi:10.1016/j.ejca.2014.07.019. 2014.
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