Screening and Treatment of DCIS Reduces Number of Invasive Breast Cancers

Prof Stephen Duffy BSc MSc CStat Professor Of Cancer Screening Wolfson Institute Of Preventive Medicine Queen Mary University of London

Prof. Stephen W. Duffy

MedicalResearch.com Interview with:
Prof Stephen Duffy BSc MSc CStat
Professor Of Cancer Screening
Wolfson Institute Of Preventive Medicine
Queen Mary University of London

Medical Research: What is the background for this study? What are the main findings?

Prof. Duffy: There is debate on the value of diagnosing and treating ductal carcinoma in situ (DCIS) of the breast, depending mainly on different theories about the risk of progression to invasive breast cancer if DCIS were untreated. No-one asserts that no DCIS is progressive and no-one asserts that all DCIS is progressive. There is, however, a range of opinions on the proportion of progressive disease.

We found that those mammography screening units in the UK with higher detection rates of DCIS had lower subsequent rates of invasive cancers in the three years after screening.

Medical Research: What should clinicians and patients take away from your report?

Prof. Duffy: This is another piece in the jigsaw puzzle about progression of DCIS. It adds to the findings of two randomised screening trials that diagnosis of DCIS is accompanied by reduced future incidence of invasive breast cancer and of one trial of treatment of DCIS which found that in DCIS patients treated with complete local excision alone, 30% had a subsequent breast event in the ten years following.

This provides further evidence from a service screening programme that diagnosis and treatment of DCIS prevents the occurrence of invasive disease in the future in a substantial number of cases.

Medical Research: What recommendations do you have for future research as a result of this study?

Prof. Duffy: Future research should identify better stratification of cancers with respect to their progressive and aggressive potential. This should be accompanied by the development of light touch treatment and management protocols for ‘minimal’ breast cancer. In the developed world now, large numbers of very early breast cancers are diagnosed and we need to avoid overtreating these.

Citation:

Screening-based detection of ductal carcinoma in situ and subsequent incidence of invasive interval breast cancers:a retrospective population-based study

DOI: http://dx.doi.org/10.1016/S1470-2045(15)00446-5

Prof Stephen Duffy BSc MSc CStat (2015). Screening and Treatment of DCIS Reduces Number of Invasive Breast Cancers 

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