High-grade DCIS Detection Rates Increase with Age

Mammography detects more ductal carcinoma in situ (DCIS) as women get older, according to a large new study published in Radiology.

German researchers undertook a retrospective study to investigate the association between age at mammography screening and detection of DCIS.

Data from 733,905 women, aged 50 to 69 participating in a screening program, were collected for the study. They had undergone first-time screening mammograms from 2005 to 2008. The women were divided into four groups: 50 to 54 years, 55 to 59 years, 60 to 64 years, and 65 to 69 years.

Among the 733,905 women, there were 989 graded DCIS diagnosis, for a detection rate of 1.35%:

• 419 diagnoses of high-grade DCIS (detection rate, 0.57%)[[{"type":"media","view_mode":"media_crop","fid":"43255","attributes":{"alt":"Stefanie Weigel, MD","class":"media-image media-image-right","id":"media_crop_6384941066993","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4710","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 150px; width: 100px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]

• 388 diagnoses of intermediate-grade DCIS (detection rate, 0.53%)

• 182 diagnoses of low-grade DCIS (detection rate, 0.25%)

The detection rate for all DCIS combined increased significantly across age groups:

“The detection rate of high-grade DCIS in our collective showed a statistically significant increase with age, with a maximum rate at the oldest assessed age group of 65 to 69 years,” lead author, Stefanie Weigel, MD, University Hospital Muenster, Germany, said in a release.

“Adequate therapy of non-symptomatic high-grade DCIS detected at screening needs further evaluation, as there is the chance to prevent aggressive invasive breast cancer, which could be life-threatening even in older age groups,” Weigel said. “In terms of overdiagnosis and overtreatment, there is need for more detailed prognostic characterization of DCIS lesions and weighting them in the context of age.”