The mammography screening detection of ductal carcinoma in situ and invasive breast cancer according to women’s characteristics: is it the same?
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Detection of ductal carcinoma in situ (DCIS) has increased with the mammography dissemination. Given the potential role of DCIS as a precursor of invasive breast cancer (IBC), we aimed to assess whether women’s characteristics have a different effect on the DCIS compared to IBC detection rate.
This study included 3,609,569 screening mammograms performed from 2002 to 2015 in our organized breast cancer screening program, which actively invites women 50–69 years of age. The association between women’s characteristics and the DCIS detection rate, the IBC detection rate and the odds ratio of DCIS among screen-detected cancers was assessed by logistic regression and generalized estimating equations with independent correlation matrix and sandwich estimator.
A total of 4173 DCIS and 15,136 IBC were screen-detected. Increasing women’s age, current hormone replacement therapy use and higher body mass index were less associated with the DCIS than with IBC detection rates (p value for the odds of DCIS among screen-detected cancers of, respectively, < 0.0001, 0.0244 and < 0.0001). In contrast, having a previous breast aspiration or biopsy and increasing breast density were more strongly associated with DCIS than with IBC detection rates (p value of, respectively, 0.0050 and < 0.0001).
The results suggest that some women’s characteristics could be playing a role in the initiation and other in the progression from in situ to invasive breast cancer. These characteristics can also affect the screening sensitivity, and this effect may differ depending on whether screen-detected cases were DCIS or IBC.
KeywordsBreast cancer Mammography Screening Detection rate Ductal carcinoma in situ
Body mass index
Cancer detection rate
Ductal carcinoma in situ
Generalized estimating equations
Hormone replacement therapy
Invasive breast cancer
International Classification of Diseases, 9th edition
International Classification of Diseases, 10th edition
Programme québécois de dépistage du cancer du sein (Quebec Breast Cancer Screening Program)
This study was financially supported by the Direction générale de cancérologie of the Quebec Ministry of Health and Social Services.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All women included in this analysis signed a consent form agreeing to participate in the PQDCS, which includes transmission of their data to central database for analysis.
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