Ernster V L, Barclay J
Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, USA.
J Natl Cancer Inst Monogr. 1997(22):151-6. doi: 10.1093/jncimono/1997.22.151.
The increased use of screening mammography has resulted in a marked increase in detected cases of ductal carcinoma in situ (DCIS) of the breast since the early 1980s. In 1993, there were an estimated 23,275 newly diagnosed cases of DCIS in the United States, of which 4,676 were in women aged 40-49. DCIS accounted for 14.7% of all newly diagnosed breast cancers in women aged 40-49 in 1993, and perhaps 40% of all mammographically detected breast cancers in this age group are DCIS. Among women aged 40-49, an estimated 1,890 mastectomies and 2,707 lumpectomies (with or without radiation) were performed for DCIS in 1993. There is an urgent need to better understand the relationship of mammographically detected DCIS to invasive and potentially life-threatening breast cancer. Better information about the appropriate treatment of DCIS is also needed to reduce the confusion and uncertainty many women and their physicians currently experience in the face of a DCIS diagnosis. For the present, women considering screening mammography should be told the likelihood of being diagnosed with DCIS and that only some DCIS cases may be clinically significant but almost all will be treated surgically.
自20世纪80年代初以来，乳腺钼靶筛查的使用增加，导致乳腺导管原位癌（DCIS）的检出病例显著增加。1993年，美国估计有23275例新诊断的DCIS病例，其中4676例发生在40至49岁的女性中。1993年，DCIS占40至49岁女性所有新诊断乳腺癌的14.7%，在这个年龄组中，通过乳腺钼靶检测出的所有乳腺癌中，可能有40%是DCIS。在40至49岁的女性中，1993年估计有1890例因DCIS进行了乳房切除术，2707例进行了肿块切除术（有或无放疗）。迫切需要更好地了解通过乳腺钼靶检测出的DCIS与侵袭性及可能危及生命的乳腺癌之间的关系。还需要更好地了解DCIS的适当治疗方法，以减少许多女性及其医生在面对DCIS诊断时目前所经历的困惑和不确定性。目前，应该告知考虑进行乳腺钼靶筛查的女性被诊断为DCIS的可能性，以及只有一些DCIS病例可能具有临床意义，但几乎所有病例都将接受手术治疗。
