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Invasive Breast Cancer, Breast Cancer Mortality Increased Long Term After DCIS

Highest cumulative risks for invasive breast cancer and breast cancer death seen for women aged younger than 45 years at diagnosis

By Elana Gotkine HealthDay Reporter

THURSDAY, Jan. 25, 2024 (HealthDay News) — Women with non-screen-detected ductal carcinoma in situ have an increased risk for invasive breast cancer and breast cancer death, according to a study published online Jan. 24 in The BMJ.

Gurdeep S. Mannu, M.B.B.S., D.Phil., from the University of Oxford in the United Kingdom, and colleagues examined the long-term risks for invasive cancer and death related to breast cancer after non-screen-detected ductal carcinoma in situ among 27,543 women in England who were diagnosed during 1990 to 2018, outside the National Health Service breast screening program.

The researchers found that by Dec. 31, 2018, 3,651 women with non-screen-detected ductal carcinoma in situ had developed invasive breast cancer (ratio of observed to expected rate, 4.21). Throughout follow-up, the ratio of observed to expected rate of developing invasive breast cancer remained elevated among women aged younger than 45 to 70 years. The 25-year cumulative risks for invasive breast cancer were 27.3, 25.2, 21.7, and 20.8 percent for those with a diagnosis of ductal carcinoma in situ at age younger than 45, 45 to 49, 50 to 59, and 60 to 70 years, respectively. Overall, 908 women died of breast cancer (ratio of observed to expected rate, 3.83); the ratio remained elevated throughout follow-up. The 25-year cumulative risks for breast cancer death were 7.6, 5.8, 5.9, and 6.2 percent, respectively, by age at diagnosis.

“These findings should inform considerations regarding the frequency and duration of surveillance following a diagnosis of ductal carcinoma in situ, particularly for women diagnosed at younger ages,” the authors write.

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