US study shows wide variation in approach to ductal carcinoma in situ

Some women in the United States with ductal carcinoma in situ (DCIS) are under-treated, not receiving recommended radiation even when they have risk factors indicating its use, and others are over-treated with mastectomy and axillary dissection. Treatment depends on where women live, reported a study published last week.

The study used data from the US National Cancer Institute's surveillance, epidemiology, and end results database (SEER) to review the treatment of 25 206 patients with DCIS, a pre-cancerous growth, from 1992 to 1999 at 11 different sites. Results showed that where a woman lived was a significant predictor of the use of breast conserving therapy, radiotherapy after surgery, and axillary dissection (P<0.001). …