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Contempo Updates
January 26, 2000

Treatment Selection in Ductal Carcinoma In Situ

Author Affiliations

Author Affiliations: Department of Surgery and Lynn Sage Comprehensive Breast Center, Northwestern University Medical School, Chicago, Ill (Dr Morrow); Department of Pathology, Beth Israel Hospital, Harvard Medical School, Boston, Mass (Dr Schnitt).


Contempo Updates Section Editors: Thomas C. Jefferson, MD, Contributing Editor; Stephen J. Lurie, MD, PhD, Fishbein Fellow.

JAMA. 2000;283(4):453-455. doi:10.1001/jama.283.4.453

Ductal carcinoma in situ (DCIS) is a proliferation of presumably malignant epithelial cells within the mammary ductal-lobular system without evidence of invasion. In the past, DCIS was uncommon, accounting for only 2% of 10,000 cancer cases treated in 1980.1 Between 1973 and 1992, age-adjusted DCIS incidence rates increased by 587%, while the incidence of invasive carcinoma increased by 34.3%.2 This increase was almost entirely confined to women older than 40 years and is thought to be due to the increased use of screening mammography. This has led to speculation that screening mammography may detect biologically indolent DCIS that is unlikely to become clinically significant.2

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