International variation in management of screen-detected ductal carcinoma in situ of the breast

Research output: Contribution to journalJournal articleResearchpeer-review

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International variation in management of screen-detected ductal carcinoma in situ of the breast. / Ponti, Antonio; Lynge, Elsebeth; James, Ted; Májek, Ondřej; von Euler-Chelpin, My; 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; ICSN DCIS Working group.

In: European journal of cancer (Oxford, England : 1990), Vol. 50, No. 15, 01.10.2014, p. 2695-704.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Ponti, A, Lynge, E, James, T, Májek, O, von Euler-Chelpin, M, Anttila, A, Fitzpatrick, P, Mano, MP, Kawai, M, Scharpantgen, A, Fracheboud, J, Hofvind, S, Vidal, C, Ascunce, N, Salas, D, Bulliard, J-L, Segnan, N, Kerlikowske, K, Taplin, S & ICSN DCIS Working group 2014, 'International variation in management of screen-detected ductal carcinoma in situ of the breast', European journal of cancer (Oxford, England : 1990), vol. 50, no. 15, pp. 2695-704. https://doi.org/10.1016/j.ejca.2014.07.019

APA

Ponti, A., Lynge, E., James, T., Májek, O., von Euler-Chelpin, M., Anttila, A., ... ICSN DCIS Working group (2014). International variation in management of screen-detected ductal carcinoma in situ of the breast. European journal of cancer (Oxford, England : 1990), 50(15), 2695-704. https://doi.org/10.1016/j.ejca.2014.07.019

Vancouver

Ponti A, Lynge E, James T, Májek O, von Euler-Chelpin M, Anttila A et al. International variation in management of screen-detected ductal carcinoma in situ of the breast. European journal of cancer (Oxford, England : 1990). 2014 Oct 1;50(15):2695-704. https://doi.org/10.1016/j.ejca.2014.07.019

Author

Ponti, Antonio ; Lynge, Elsebeth ; James, Ted ; Májek, Ondřej ; von Euler-Chelpin, My ; 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 ; ICSN DCIS Working group. / International variation in management of screen-detected ductal carcinoma in situ of the breast. In: European journal of cancer (Oxford, England : 1990). 2014 ; Vol. 50, No. 15. pp. 2695-704.

Bibtex

@article{e7c149f6c2ff45d382b4e72dd718248c,
title = "International variation in management of screen-detected ductal carcinoma in situ of the breast",
abstract = "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.",
keywords = "Aged, Breast Neoplasms, Carcinoma, Intraductal, Noninfiltrating, Early Detection of Cancer, Europe, Female, Humans, International Agencies, Japan, Lymph Node Excision, Mastectomy, Segmental, Middle Aged, Outcome Assessment (Health Care), Radiotherapy, United States",
author = "Antonio Ponti and Elsebeth Lynge and Ted James and Ondřej M{\'a}jek and {von Euler-Chelpin}, My and Ahti Anttila and Patricia Fitzpatrick and Mano, {Maria Piera} and Masaaki Kawai and Astrid Scharpantgen and Jacques Fracheboud and Solveig Hofvind and Carmen Vidal and Nieves Ascunce and Dolores Salas and Jean-Luc Bulliard and Nereo Segnan and Karla Kerlikowske and Stephen Taplin and {ICSN DCIS Working group}",
note = "Copyright {\circledC} 2014 Elsevier Ltd. All rights reserved.",
year = "2014",
month = "10",
day = "1",
doi = "10.1016/j.ejca.2014.07.019",
language = "English",
volume = "50",
pages = "2695--704",
journal = "European Journal of Cancer",
issn = "0959-8049",
publisher = "Pergamon",
number = "15",

}

RIS

TY - JOUR

T1 - International variation in management of screen-detected ductal carcinoma in situ of the breast

AU - Ponti, Antonio

AU - Lynge, Elsebeth

AU - James, Ted

AU - Májek, Ondřej

AU - von Euler-Chelpin, My

AU - Anttila, Ahti

AU - Fitzpatrick, Patricia

AU - Mano, Maria Piera

AU - Kawai, Masaaki

AU - Scharpantgen, Astrid

AU - Fracheboud, Jacques

AU - Hofvind, Solveig

AU - Vidal, Carmen

AU - Ascunce, Nieves

AU - Salas, Dolores

AU - Bulliard, Jean-Luc

AU - Segnan, Nereo

AU - Kerlikowske, Karla

AU - Taplin, Stephen

AU - ICSN DCIS Working group

N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.

PY - 2014/10/1

Y1 - 2014/10/1

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.

AB - 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.

KW - Aged

KW - Breast Neoplasms

KW - Carcinoma, Intraductal, Noninfiltrating

KW - Early Detection of Cancer

KW - Europe

KW - Female

KW - Humans

KW - International Agencies

KW - Japan

KW - Lymph Node Excision

KW - Mastectomy, Segmental

KW - Middle Aged

KW - Outcome Assessment (Health Care)

KW - Radiotherapy

KW - United States

U2 - 10.1016/j.ejca.2014.07.019

DO - 10.1016/j.ejca.2014.07.019

M3 - Journal article

C2 - 25149183

VL - 50

SP - 2695

EP - 2704

JO - European Journal of Cancer

JF - European Journal of Cancer

SN - 0959-8049

IS - 15

ER -

ID: 135653233