Incidence of and Treatment for Ductal Carcinoma In Situ of the Breast

摘要: Objective. —To describe trends in incidence and treatment for ductal carcinoma situ (DCIS) of the breast United States between 1973 1992 to estimate total numbers cases diagnosed treated by mastectomy since 1983, when screening mammography cancer began become widespread. Design. —Analysis population-based data collected National Cancer Institute's Surveillance, Epidemiology, End Results (SEER) program SEER 1983. Study Population. —All women geographic areas included program. Main Outcome Measures. —Annual age-adjusted age-specific rates DCIS; time distribution type treatment; percentage area; estimated entire DCIS cases, mastectomies DCIS, attributable mammography. Results. —There was a marked increase beginning early 1980s. Average annual increases 1983 changed from 0.3% 12.0% among aged 30 39 years, 0.4% 17.4% 40 49 5.2% 18.1% 50 years or older. The number (23368) 200% higher than expected based on Between 1992, there decline proportion (from 71% 43.8%) an those lumpectomy 25.6% 53.3%). In 23.3% were radiation, 30.2% alone, 2.6% with no surgery. Treatment patterns varied substantially area, 57.7% New Mexico compared 28.8% Connecticut. Despite mastectomy, increased resulted absolute until 1990 (n=10657); 10242 mastectomy. Conclusions —Incidence have dramatically This correlates widespread adoption modern mammographic screening. While detection invasive is beneficial, value currently unknown. There cause concern about large that are being as consequence mammography, most which some form addition, may be inappropriately high, particularly States. ( JAMA . 1996;275:913-918)