DCIS often not monitored after surgery

Women who undergo breast-conserving surgery for ductal carcinoma in situ (DCIS) often do not receive long-term surveillance mammography, according to a study published online May 11 in the Journal of Clinical Oncology.

Larissa Nekhlyudov, MD, from Harvard Medical School in Boston, and colleagues reviewed the medical records of 3,037 women who were treated with breast-conserving surgery for DCIS.

After observation for a median of 4.8 years, the researchers found that the percentage of women undergoing surveillance mammography fell from 79% after 1 year to 61% after 10 years. Among women observed for at least 5 years, the likelihood of receiving surveillance mammography was higher for women in their 60s (odds ratio, 1.72), women receiving menopausal hormone therapy at diagnosis (odds ratio, 1.26), and women receiving adjuvant radiation (odds ratio, 1.28) and radiation with tamoxifen (odds ratio, 1.61). Obese women were less likely to undergo mammography (odds ratio, 0.70).

"In summary, we found that surveillance mammography after breast-conserving surgery for DCIS among insured women often did not occur yearly and that surveillance declined over time,"

Nekhlyudov and colleagues conclude. "Because DCIS is considered to be a precursor to invasive breast cancer, it is particularly important for women to receive surveillance for recurrences of DCIS and/or newly diagnosed invasive breast cancer."Nekhlyudov L, Habel LA, Achacoso NS, et al. Adherence to long-term surveillance mammography among women with ductal carcinoma in situ treated with breast-conserving surgery. J Clin Oncol. 2009 May 11. [Epub ahead of print]. Doi:10.1200/JCO.2008.18.5876.