Detection of ductal carcinoma in situ in women undergoing screening mammography

Virginia L. Ernster, Rachel Ballard-Barbash, William E. Barlow, Yingye Zheng, Donald L. Weaver, Gary Cutter, Bonnie C. Yankaskas, Robert Rosenberg, Patricia (Patty) Carney, Karla Kerlikowske, Stephen H. Taplin, Nicole Urban, Berta M. Geller

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Abstract

Background: With the large number of women having mammography-an estimated 28.4 million U.S. women aged 40 years and older in 1998-the percentage of cancers detected as ductal carcinoma in situ (DCIS), which has an uncertain prognosis, has increased. We pooled data from seven regional mammography registries to determine the percentage of mammographically detected cancers that are DCIS and the rate of DCIS per 1000 mammograms. Methods: We analyzed data on 653 833 mammograms from 540738 women between 40 and 84 years of age who underwent screening mammography at facilities participating in the National Cancer Institute's Breast Cancer Surveillance Consortium (BCSC) throughout 1996 and 1997. Mammography results were linked to population-based cancer and pathology registries. We calculated the percentage of screen-detected breast cancers that were DCIS, the rate of screen-detected DCIS per 1000 mammograms by age and by previous mammography status, and the sensitivity of screening mammography. Statistical tests were two-sided. Results: A total of 3266 cases of breast cancer were identified, 591 DCIS and 2675 invasive breast cancer. The percentage of screen-detected breast cancers that were DCIS decreased with age (from 28.2% [95% confidence interval (CI) = 23.9% to 32.5%] for women aged 40-49 years to 16.0% [95% CI = 13.3% to 18.7%] for women aged 70-84 years). However, the rate of screen-detected DCIS cases per 1000 mammograms increased with age (from 0.56 [95% CI = 0.41 to 0.70] for women aged 40-49 years to 1.07 [95% CI = 0.87 to 1.27] for women aged 70-84 years). Sensitivity of screening mammography in all age groups combined was higher for detecting DCIS (86.0% [95% CI = 83.2% to 88.8%]) than it was for detecting invasive breast cancer (75.1% [95% CI = 73.5% to 76.8%]). Conclusions: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS. Given uncertainty about the natural history of DCIS, the clinical significance of screen-detected DCIS needs further investigation.

Original languageEnglish (US)
Pages (from-to)1546-1554
Number of pages9
JournalJournal of the National Cancer Institute
Volume94
Issue number20
StatePublished - Oct 16 2002
Externally publishedYes

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Carcinoma, Intraductal, Noninfiltrating
Mammography
Breast Neoplasms
Confidence Intervals
Registries
Neoplasms
National Cancer Institute (U.S.)
Uncertainty
Age Groups

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ernster, V. L., Ballard-Barbash, R., Barlow, W. E., Zheng, Y., Weaver, D. L., Cutter, G., ... Geller, B. M. (2002). Detection of ductal carcinoma in situ in women undergoing screening mammography. Journal of the National Cancer Institute, 94(20), 1546-1554.

Detection of ductal carcinoma in situ in women undergoing screening mammography. / Ernster, Virginia L.; Ballard-Barbash, Rachel; Barlow, William E.; Zheng, Yingye; Weaver, Donald L.; Cutter, Gary; Yankaskas, Bonnie C.; Rosenberg, Robert; Carney, Patricia (Patty); Kerlikowske, Karla; Taplin, Stephen H.; Urban, Nicole; Geller, Berta M.

In: Journal of the National Cancer Institute, Vol. 94, No. 20, 16.10.2002, p. 1546-1554.

Research output: Contribution to journalArticle

Ernster, VL, Ballard-Barbash, R, Barlow, WE, Zheng, Y, Weaver, DL, Cutter, G, Yankaskas, BC, Rosenberg, R, Carney, PP, Kerlikowske, K, Taplin, SH, Urban, N & Geller, BM 2002, 'Detection of ductal carcinoma in situ in women undergoing screening mammography', Journal of the National Cancer Institute, vol. 94, no. 20, pp. 1546-1554.
Ernster VL, Ballard-Barbash R, Barlow WE, Zheng Y, Weaver DL, Cutter G et al. Detection of ductal carcinoma in situ in women undergoing screening mammography. Journal of the National Cancer Institute. 2002 Oct 16;94(20):1546-1554.
Ernster, Virginia L. ; Ballard-Barbash, Rachel ; Barlow, William E. ; Zheng, Yingye ; Weaver, Donald L. ; Cutter, Gary ; Yankaskas, Bonnie C. ; Rosenberg, Robert ; Carney, Patricia (Patty) ; Kerlikowske, Karla ; Taplin, Stephen H. ; Urban, Nicole ; Geller, Berta M. / Detection of ductal carcinoma in situ in women undergoing screening mammography. In: Journal of the National Cancer Institute. 2002 ; Vol. 94, No. 20. pp. 1546-1554.
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abstract = "Background: With the large number of women having mammography-an estimated 28.4 million U.S. women aged 40 years and older in 1998-the percentage of cancers detected as ductal carcinoma in situ (DCIS), which has an uncertain prognosis, has increased. We pooled data from seven regional mammography registries to determine the percentage of mammographically detected cancers that are DCIS and the rate of DCIS per 1000 mammograms. Methods: We analyzed data on 653 833 mammograms from 540738 women between 40 and 84 years of age who underwent screening mammography at facilities participating in the National Cancer Institute's Breast Cancer Surveillance Consortium (BCSC) throughout 1996 and 1997. Mammography results were linked to population-based cancer and pathology registries. We calculated the percentage of screen-detected breast cancers that were DCIS, the rate of screen-detected DCIS per 1000 mammograms by age and by previous mammography status, and the sensitivity of screening mammography. Statistical tests were two-sided. Results: A total of 3266 cases of breast cancer were identified, 591 DCIS and 2675 invasive breast cancer. The percentage of screen-detected breast cancers that were DCIS decreased with age (from 28.2{\%} [95{\%} confidence interval (CI) = 23.9{\%} to 32.5{\%}] for women aged 40-49 years to 16.0{\%} [95{\%} CI = 13.3{\%} to 18.7{\%}] for women aged 70-84 years). However, the rate of screen-detected DCIS cases per 1000 mammograms increased with age (from 0.56 [95{\%} CI = 0.41 to 0.70] for women aged 40-49 years to 1.07 [95{\%} CI = 0.87 to 1.27] for women aged 70-84 years). Sensitivity of screening mammography in all age groups combined was higher for detecting DCIS (86.0{\%} [95{\%} CI = 83.2{\%} to 88.8{\%}]) than it was for detecting invasive breast cancer (75.1{\%} [95{\%} CI = 73.5{\%} to 76.8{\%}]). Conclusions: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS. Given uncertainty about the natural history of DCIS, the clinical significance of screen-detected DCIS needs further investigation.",
author = "Ernster, {Virginia L.} and Rachel Ballard-Barbash and Barlow, {William E.} and Yingye Zheng and Weaver, {Donald L.} and Gary Cutter and Yankaskas, {Bonnie C.} and Robert Rosenberg and Carney, {Patricia (Patty)} and Karla Kerlikowske and Taplin, {Stephen H.} and Nicole Urban and Geller, {Berta M.}",
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T1 - Detection of ductal carcinoma in situ in women undergoing screening mammography

AU - Ernster, Virginia L.

AU - Ballard-Barbash, Rachel

AU - Barlow, William E.

AU - Zheng, Yingye

AU - Weaver, Donald L.

AU - Cutter, Gary

AU - Yankaskas, Bonnie C.

AU - Rosenberg, Robert

AU - Carney, Patricia (Patty)

AU - Kerlikowske, Karla

AU - Taplin, Stephen H.

AU - Urban, Nicole

AU - Geller, Berta M.

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N2 - Background: With the large number of women having mammography-an estimated 28.4 million U.S. women aged 40 years and older in 1998-the percentage of cancers detected as ductal carcinoma in situ (DCIS), which has an uncertain prognosis, has increased. We pooled data from seven regional mammography registries to determine the percentage of mammographically detected cancers that are DCIS and the rate of DCIS per 1000 mammograms. Methods: We analyzed data on 653 833 mammograms from 540738 women between 40 and 84 years of age who underwent screening mammography at facilities participating in the National Cancer Institute's Breast Cancer Surveillance Consortium (BCSC) throughout 1996 and 1997. Mammography results were linked to population-based cancer and pathology registries. We calculated the percentage of screen-detected breast cancers that were DCIS, the rate of screen-detected DCIS per 1000 mammograms by age and by previous mammography status, and the sensitivity of screening mammography. Statistical tests were two-sided. Results: A total of 3266 cases of breast cancer were identified, 591 DCIS and 2675 invasive breast cancer. The percentage of screen-detected breast cancers that were DCIS decreased with age (from 28.2% [95% confidence interval (CI) = 23.9% to 32.5%] for women aged 40-49 years to 16.0% [95% CI = 13.3% to 18.7%] for women aged 70-84 years). However, the rate of screen-detected DCIS cases per 1000 mammograms increased with age (from 0.56 [95% CI = 0.41 to 0.70] for women aged 40-49 years to 1.07 [95% CI = 0.87 to 1.27] for women aged 70-84 years). Sensitivity of screening mammography in all age groups combined was higher for detecting DCIS (86.0% [95% CI = 83.2% to 88.8%]) than it was for detecting invasive breast cancer (75.1% [95% CI = 73.5% to 76.8%]). Conclusions: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS. Given uncertainty about the natural history of DCIS, the clinical significance of screen-detected DCIS needs further investigation.

AB - Background: With the large number of women having mammography-an estimated 28.4 million U.S. women aged 40 years and older in 1998-the percentage of cancers detected as ductal carcinoma in situ (DCIS), which has an uncertain prognosis, has increased. We pooled data from seven regional mammography registries to determine the percentage of mammographically detected cancers that are DCIS and the rate of DCIS per 1000 mammograms. Methods: We analyzed data on 653 833 mammograms from 540738 women between 40 and 84 years of age who underwent screening mammography at facilities participating in the National Cancer Institute's Breast Cancer Surveillance Consortium (BCSC) throughout 1996 and 1997. Mammography results were linked to population-based cancer and pathology registries. We calculated the percentage of screen-detected breast cancers that were DCIS, the rate of screen-detected DCIS per 1000 mammograms by age and by previous mammography status, and the sensitivity of screening mammography. Statistical tests were two-sided. Results: A total of 3266 cases of breast cancer were identified, 591 DCIS and 2675 invasive breast cancer. The percentage of screen-detected breast cancers that were DCIS decreased with age (from 28.2% [95% confidence interval (CI) = 23.9% to 32.5%] for women aged 40-49 years to 16.0% [95% CI = 13.3% to 18.7%] for women aged 70-84 years). However, the rate of screen-detected DCIS cases per 1000 mammograms increased with age (from 0.56 [95% CI = 0.41 to 0.70] for women aged 40-49 years to 1.07 [95% CI = 0.87 to 1.27] for women aged 70-84 years). Sensitivity of screening mammography in all age groups combined was higher for detecting DCIS (86.0% [95% CI = 83.2% to 88.8%]) than it was for detecting invasive breast cancer (75.1% [95% CI = 73.5% to 76.8%]). Conclusions: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS. Given uncertainty about the natural history of DCIS, the clinical significance of screen-detected DCIS needs further investigation.

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