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Characterizing the impact of 25 years of DCIS treatment.

Publication ,  Journal Article
Ozanne, EM; Shieh, Y; Barnes, J; Bouzan, C; Hwang, ES; Esserman, LJ
Published in: Breast Cancer Res Treat
August 2011

The significant increase in the detection and treatment of ductal carcinoma in situ (DCIS) since the introduction of screening mammography has not been accompanied by the anticipated reduction in invasive breast cancer (IBC) incidence. The prevalence of DCIS requires a reexamination of the population level effects of detecting and treating DCIS. To further our understanding of the possible impact of DCIS diagnosis and treatment on IBC incidence in the U.S., we simulated breast cancer incidence over 25 years under various assumptions regarding the baseline incidence of IBC and the progression of DCIS to IBC. The simulations demonstrate a tradeoff between the expected increased incidence of IBC absent any DCIS detection and treatment and the rate of progression of DCIS to IBC. Our analyses indicate that a high progression of DCIS to IBC implies a significant increase in incidence of IBC over what is observed had we not detected and treated DCIS. Conversely, if we assume that there would not have been a significant increase over and above the observed incidence evident in SEER, then our model indicates that the rate of DCIS progression to clinically significant IBC is low. Given the tradeoff illustrated by our model, we must reevaluate the assumption that DCIS is a short-term obligate precursor of invasive cancer and instead focus on further exploration of the true natural history of DCIS.

Duke Scholars

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Published In

Breast Cancer Res Treat

DOI

EISSN

1573-7217

Publication Date

August 2011

Volume

129

Issue

1

Start / End Page

165 / 173

Location

Netherlands

Related Subject Headings

  • SEER Program
  • Oncology & Carcinogenesis
  • Models, Statistical
  • Mass Screening
  • Incidence
  • Humans
  • Female
  • Disease Progression
  • Computer Simulation
  • Carcinoma, Intraductal, Noninfiltrating
 

Citation

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Ozanne, E. M., Shieh, Y., Barnes, J., Bouzan, C., Hwang, E. S., & Esserman, L. J. (2011). Characterizing the impact of 25 years of DCIS treatment. Breast Cancer Res Treat, 129(1), 165–173. https://doi.org/10.1007/s10549-011-1430-5
Ozanne, Elissa M., Yiwey Shieh, James Barnes, Colleen Bouzan, E Shelley Hwang, and Laura J. Esserman. “Characterizing the impact of 25 years of DCIS treatment.Breast Cancer Res Treat 129, no. 1 (August 2011): 165–73. https://doi.org/10.1007/s10549-011-1430-5.
Ozanne EM, Shieh Y, Barnes J, Bouzan C, Hwang ES, Esserman LJ. Characterizing the impact of 25 years of DCIS treatment. Breast Cancer Res Treat. 2011 Aug;129(1):165–73.
Ozanne, Elissa M., et al. “Characterizing the impact of 25 years of DCIS treatment.Breast Cancer Res Treat, vol. 129, no. 1, Aug. 2011, pp. 165–73. Pubmed, doi:10.1007/s10549-011-1430-5.
Ozanne EM, Shieh Y, Barnes J, Bouzan C, Hwang ES, Esserman LJ. Characterizing the impact of 25 years of DCIS treatment. Breast Cancer Res Treat. 2011 Aug;129(1):165–173.
Journal cover image

Published In

Breast Cancer Res Treat

DOI

EISSN

1573-7217

Publication Date

August 2011

Volume

129

Issue

1

Start / End Page

165 / 173

Location

Netherlands

Related Subject Headings

  • SEER Program
  • Oncology & Carcinogenesis
  • Models, Statistical
  • Mass Screening
  • Incidence
  • Humans
  • Female
  • Disease Progression
  • Computer Simulation
  • Carcinoma, Intraductal, Noninfiltrating