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Comment & Response
March 2018

Role of Preoperative Variables in Reducing the Rate of Occult Invasive Disease for Women Considering Active Surveillance for Ductal Carcinoma In Situ

Author Affiliations
  • 1Department of Radiology, Duke University, Durham, North Carolina
  • 2Department of Surgery, Duke University, Durham, North Carolina
  • 3Department of Mathematics, Duke University, Durham, North Carolina
  • 4Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
JAMA Surg. 2018;153(3):290-291. doi:10.1001/jamasurg.2017.5566

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

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