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NIH State-of-the-Science Statement on Breast DCIS

Posted Oct 12 2009 12:00am

The conference statement from the recent NIH "State-of-the-Science" conference on ductal carcinoma-in situ (held September 22-24, 2009) is available online.  You can download a pdf for free.

Some interesting findings:

  1. While the incidence of "noncomedo" DCIS continues to increase, the incidence of the (to me, more biologically worrisome) comedo type peaked in 1995 and has been declining (through 2006).
  2. MRI in DCIS?  Most studies show that MRI is more sensitive in detecting multicentric disease but is not specific.  MRI also reportedly over- and under-estimates the extent of DCIS compared to pathological exam.
  3. Although the absolute numbers are small (due to the overall high survival rates in DCIS), there are higher breast cancer recurrence and mortality rates in Black women diagnosed with DCIS compared with White women.
  4. No molecular markers have been identified to stratify prognostic groups.  High grade, comedo pattern, margin involvement and size have been related to increased risk of recurrent DCIS and progression to invasive carcinoma--but hard numbers are hard to come by.
  5. DCIS is a heterogenous disease with a high probability of long-term disease-free survival--whatever therapy is received.
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