Vl. Ernster et al., Mortality among women with ductal carcinoma in situ of the breast in the population-based surveillance, epidemiology and end results program, ARCH IN MED, 160(7), 2000, pp. 953-958
Citations number
26
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Background: Over 14% of breast cancers diagnosed in the United States annua
lly are ductal carcinomas in situ (DCIS). There are no published population
-based reports of the likelihood of breast cancer death among US women with
DCIS.
Methods: We used data from the Surveillance, Epidemiology and End Results p
rogram to determine the likelihood of breast cancer death at 5 and 10 years
among US women aged 40 and older diagnosed with DCIS from 1978 to 1983 (be
fore screening mammography was common; n = 1525) and from 1984 to 1989 (whe
n screening mammography became common; n = 5547). We also calculated standa
rdized mortality ratios (SMRs) to compare observed deaths from breast cance
r, cardiovascular disease, and all causes combined among women with DCIS wi
th deaths expected based on general population mortality rates.
Results: Among women diagnosed with DCIS from 1978 to 1983, 1.5% died of br
east cancer within 5 years and 3.4% within 10 years. Among women diagnosed
from 1984 to 1989, 0.7% died of breast cancer within 5 years and 1.9% withi
n 10 years. Relative to the general population, risk of breast cancer death
was greater for women diagnosed from 1978 to 1983 (SMR, 3.4; 95% confidenc
e interval [CI], 2.5-4.5) than for women diagnosed from 1984 to 1989 (10-ye
ar SMR, 1.9; 95% CI, 1.5-2.3). Women diagnosed from 1984 to 1989 were signi
ficantly less likely than women in the general population to have died of c
ardiovascular diseases (10-year SMR, 0.6; 95% CI, 0.5-0.7) or of all causes
combined (SMR, 0.8; 95% CI, 0.7-0.8).
Conclusions: Among women diagnosed with DCIS, risk of death from breast can
cer was low, at least within the 10 years following diagnosis. This may ref
lect the effectiveness of treatment for DCIS, the "benign" nature of DCIS,
or both. At 10 years, women diagnosed from 1984 to 1989 were less likely th
an women diagnosed from 1978 to 1983 to have died of breast cancer, and the
ir risk of dying of all causes combined was lower than that in the general
population.