Ductal Carcinoma In Situ (DCIS)

Full Title: Diagnosis and Management of Ductal Carcinoma In Situ (DCIS)

Expected Release Date: late 2009

Key Questions*

1. What are the incidence and prevalence of DCIS and its specific pathologic subtypes, and how are incidence and prevalence influenced by mode of detection, population characteristics, and other risk factors?
   • Age.
   • Race.
   • Genetics.
   • Menopausal status.
   • Chemoprevention.
   • Menopausal HT use.
   • BMI.
   • Mammographic breast density.
2. How does the use of MRI or sentinel lymph node biopsy impact important outcomes in patients diagnosed with DCIS?
   • Mastectomy rates.
   • In-breast recurrence of DCIS or invasive cancer.
   • Rates of metastases.
   • Disease-specific survival rates.
   • Rates of chemotherapy or hormonal therapy use.
3. How do local control and systemic outcomes vary in DCIS based on tumor and patient characteristics?
   • Tumor/Patient Characteristics:
     • Specimen radiography features.
     • Margin status (width).
     • Tumor size.
     • Histological grade.
     • ER/PR status.
     • Volume of tumor evaluated.
4. In patients with DCIS, what is the impact of surgery, radiation, and systemic treatment on outcomes?
   • Systemic treatment = tamoxifen and raloxifene.
   • Outcomes:
     • Local, regional, and distant recurrence.
     • Contralateral disease.
     • Disease-specific survival.
5. What are the most critical research questions for the diagnosis and management of DCIS?

*To be addressed in evidence report.

Current as of June 2008

Internet Citation:

Diagnosis and Management of Ductal Carcinoma In Situ (DCIS), Clinical Focus. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/dcistp.htm