To the Editor We read with concern the article by Chavez de Paz Villanueva et al,1 which aimed to identify clinical risk factors for upstaging of ductal carcinoma in situ (DCIS) to invasive cancer. The topic of DCIS upstaging is timely, with 3 active surveillance (AS) trials (COMET, LORD, and LORIS trials) in progress. However, we have 2 major concerns with the work by Chavez de Paz Villanueva et al.1
Grimm LJ, Ryser MD, Hyslop T. Role of Preoperative Variables in Reducing the Rate of Occult Invasive Disease for Women Considering Active Surveillance for Ductal Carcinoma In Situ. JAMA Surg. 2018;153(3):290–291. doi:10.1001/jamasurg.2017.5566
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