Study: High-Grade DCIS Detection Increases with Age

Stefanie Weigel, MD, University Hospital Muenster
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The mammography detection rate of high-grade ductal carcinoma in situ (DCIS) — an early-stage but potentially invasive type of breast cancer — rises with age, with a maximum rate at the oldest assessed age group of 65 to 69 years, according to a new large study published in the journal Radiology. Researchers say the findings highlight the need for more research on the effectiveness of standard DCIS therapy in women older than age 60.

DCIS, which is confined to the milk ducts, is a common finding on mammography. DCIS treatment, usually in the form of surgery and radiation therapy, is controversial because some types of screening-detected DCIS may never progress to become clinically symptomatic during the patient's remaining lifetime, and treatment can result in significant costs and potential complications for the patient.

DCIS is graded based on how the cancer cells from biopsy samples look under the microscope. Although high-grade, intermediate-grade and low-grade DCIS can all develop into invasive cancer if left untreated, high-grade DCIS develops faster and becomes a more aggressive, invasive cancer.

This retrospective study included 733,905 women aged 50 to 69 years participating for the first time in a screening programme. Researchers divided the participants into five-year age groups and then determined DCIS detection rates for distinguishing high-grade, intermediate-grade and low-grade DCIS.   

Results showed that 989 of the participants (1.35 percent) had graded DCIS diagnosis, including 419 with high-grade DCIS, 388 with intermediate-grade DCIS and 182 with low-grade DCIS. Researchers also found that total DCIS detection rates increased with age, mostly due to a rise of high- and intermediate-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," says lead author Stefanie Weigel, MD, from the University Hospital Muenster in Muenster, Germany.

The findings underscore the need for more research on the effectiveness of standard DCIS therapy in women older than age 60, a group for which there are scant data, adds Dr. Weigel.

The results also provide more information to consider in the debate over screening in older women. The American Cancer Society advises women to get annual screening for as long as they are healthy, while the U.S. Preventive Services Task Force (USPSTF) recommends women stop annual screening at age 74. The USPSTF based its decision on a lack of evidence to assess the benefits and harms of screening mammography in women ages 75 and older.

According to Dr. Weigel, "The discussion about upper age limits and minimal intervals in mammography screening should be focused on effectiveness of detection of invasive cancers."   

Source and image credit: Radiological Society of North America

Published on : Tue, 27 Oct 2015



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healthmanagement, breast cancer, American Cancer Society, mammography, carcinoma, DCIS The mammography detection rate of high-grade ductal carcinoma in situ (DCIS) — an early-stage but potentially invasive type of breast cancer — rises with age, with a maximum rate at the oldest assessed age group of 65 to 69 years, according to a new lar

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