News | Breast Imaging | November 04, 2015

High-grade DCIS Detection Rates Increase in Older Women

Detection rate of high-grade DCIS showed a statistically significant increase with age, with a maximum rate at the oldest assessed age group of 65 to 69 years

DCIS, ductal carcinoma in situ, mammography detection rates, Germany, Radiology journal

November 4, 2015 — The mammography detection rate of an early-stage but potentially invasive type of breast cancer rises with age, according to a large new study from Germany published online in the journal Radiology.

Ductal carcinoma in situ (DCIS), a type of breast cancer confined to the milk ducts, is a common finding on mammography. DCIS treatment, usually in the form of surgery and radiation therapy, is controversial because some types of screening-detected DCIS may never progress to become clinically symptomatic during the patient's remaining lifetime, and treatment can result in significant costs and potential complications for the patient.

DCIS is graded based on how the cancer cells from biopsy samples look under the microscope. While high-grade, intermediate-grade and low-grade DCIS can all develop into invasive cancer if left untreated, high-grade DCIS develops faster and becomes a more aggressive, invasive cancer. Research has shown that the interval between DCIS detection and the occurrence of invasive cancer averages five years in high-grade cases.

For the retrospective study, researchers divided 733,905 women aged 50 to 69 years participating for the first time in a screening program into five-year age groups. The researchers then determined DCIS detection rates for distinguishing high-grade, intermediate-grade and low-grade DCIS.

Of the 733,905 women, 989, or 1.35 percent, had graded DCIS diagnosis, including 419 with high-grade DCIS, 388 with intermediate-grade DCIS and 182 with low-grade DCIS.

Total DCIS detection rates increased with age, mostly due to a rise of high- and intermediate-grade DCIS.

"The detection rate of high-grade DCIS in our collective showed a statistically significant increase with age, with a maximum rate at the oldest assessed age group of 65 to 69 years," said the study's lead author, Stefanie Weigel, M.D., from the University Hospital Muenster in Muenster, Germany.

The findings underscore the need for more research on the effectiveness of standard DCIS therapy in women older than age 60, a group for which there are scant data, according to Weigel. The possibility of DCIS-related overdiagnosis must be balanced against the robust evidence that high-grade DCIS is more likely to recur and to progress to invasive carcinoma, she said.

"Adequate therapy of non-symptomatic high-grade DCIS detected at screening needs further evaluation, as there is the chance to prevent aggressive invasive breast cancer, which could be life-threatening even in older age groups," Weigel said. "In terms of overdiagnosis and overtreatment, there is need for more detailed prognostic characterization of DCIS lesions and weighting them in the context of age."

The results also provide more information to consider in the debate over screening in older women. The American Cancer Society advises women to get annual screening for as long as they are healthy, while the U.S. Preventive Services Task Force (USPSTF) recommends women stop annual screening at age 74. The USPSTF based its decision on a lack of evidence to assess the benefits and harms of screening mammography in women ages 75 and older.

"The discussion about upper age limits and minimal intervals in mammography screening should be focused on effectiveness of detection of invasive cancers," Weigel said.

For more information: http://pubs.rsna.org/journal/radiology

Related Content

Novel Technique May Significantly Reduce Breast Biopsies
News | Breast Biopsy Systems | January 17, 2019
A novel technique that uses mammography to determine the biological tissue composition of a tumor could help reduce...
Digital Mammography Increases Breast Cancer Detection
News | Mammography | January 16, 2019
The shift from film to digital mammography increased the detection of breast cancer by 14 percent overall in the United...
Artificial Intelligence Used in Clinical Practice to Measure Breast Density
News | Artificial Intelligence | January 15, 2019
An artificial intelligence (AI) algorithm measures breast density at the level of an experienced mammographer,...
Machine Learning Uncovers New Insights Into Human Brain Through fMRI
News | Neuro Imaging | January 11, 2019
An interdisciplinary research team led by scientists from the National University of Singapore (NUS) has successfully...
Sponsored Content | Videos | Breast Imaging | January 11, 2019
Supplemental screening with ABUS helps personalize breast care for women with dense breasts and offers advanced...
Mobile App Data Collection Shows Promise for Population Health Surveys
News | Population Health | January 10, 2019
Mobile app data collection can bring access to more potential clinical study participants, reduce clinical study...
Hypertension With Progressive Cerebral Small Vessel Disease Increases Cognitive Impairment Risk
News | Magnetic Resonance Imaging (MRI) | January 08, 2019
Patients with high blood pressure and progression of periventricular white matter hyperintensities showed signs of...
Artificial Intelligence Pinpoints Nine Different Abnormalities in Head Scans

A brain scan (left) showing an intraparenchymal hemorrhage in left frontal region and a scan (right) of a subarachnoid hemorrhage in the left parietal region. Both conditions were accurately detected by the Qure.ai tool. Image courtesy of Nature Medicine.

News | Artificial Intelligence | January 07, 2019
The rise in the use of computed tomography (CT) scans in U.S. emergency rooms has been a well-documented trend1 in...
Electronic Brachytherapy Effective in Long-Term Study of 1,000 Early-Stage Breast Cancers
News | Brachytherapy Systems, Women's Healthcare | January 07, 2019
Breast cancer recurrence rates of patients treated with intraoperative radiation therapy (IORT) using the Xoft Axxent...
Brachytherapy Alone Superior Treatment for Intermediate-Risk Prostate Cancer
News | Brachytherapy Systems | January 04, 2019
Patient-reported outcomes (PROs) indicated a significantly different clinician and patient-reported late toxicity...