Ductal carcinoma in situ (DCIS) of the breast: The need for psychosocial research

Since the introduction of the National Health Service Breast Screening Prog ramme (NHSBSP), the number of ductal carcinoma in situ (DCIS) cases has inc reased considerably. Despite its increased incidence, some NHS leaflets and reports do not mention it, and the general public seems largely unaware of its existence. There are numerous biological studies dealing with this con dition, but its psychosocial aspects seem to have been neglected. We have o nly been able to locate two British studies (Farmer, A. 1996. Unpublished P hD thesis, University of Southampton; Webb, C. and Koch, T. 1997. J. Adv. N urs., 25, 154-525) that address some of the psychosocial issues associated with DCIS. This paper starts by defining DCIS and explaining its usual presentation, n atural history and epidemiology. The treatment options for DCIS are describ ed, together with the great deal of confusion and lack of agreement that ac companies them. The psychological issues that women with screen-detected DC IS have to deal with are different from those affecting women diagnosed wit h symptomatic breast cancer, and a summary of these issues is given. Finall y, some suggestions for future psychosocial research are provided. Because the UK as a whole was not covered by the NHSBSP until 1990 (Baum, M. 1995. Lancet, 346, 436; Gage and Fouquet, 1997), the main focus will be on papers published from that year onwards, although some key papers published befor e then will also be included. The papers reviewed here were found in MEDLIN E, EMBASE and BIDS (ISI). Copyright (C) 1999 John Wiley & Sons, Ltd.