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From The JAMA Network
March 2016

Overtreatment of Low-Grade Ductal Carcinoma In Situ

Author Affiliations
  • 1Sussex Health Outcomes, Research & Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
  • 2Department of Breast Surgery, Nuffield House, Queen Elizabeth Hospital, Queen, Elizabeth Medical Centre, Birmingham, United Kingdom

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Oncol. 2016;2(3):382-383. doi:10.1001/jamaoncol.2015.5026

Ductal carcinoma in situ (DCIS) makes up approximately 20% to 25% of all breast cancers detected by mammographic screening programs. Such programs were set up to identify early invasive disease, so the large numbers of all grades of DCIS diagnosed were unexpected and unwelcome. As the natural history of untreated DCIS is largely unknown, its management is controversial; mammogram-detected DCIS is usually treated as if it is cancer, primarily with surgery. Adjuvant treatments may also be offered, which vary from hospital to hospital and from country to country.1 Surgery for DCIS has remained largely unchanged since the 1970s, and mastectomy is now performed more often than is seen with invasive cancer. It is 40 years since the inception of the first breast screening programs, and it is time to question the appropriateness and the outcomes of these management policies for screen-detected DCIS.

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