title: Surgical management of ductal carcinoma in situ in Australia in 1995.
abstract: BACKGROUND
  In the present paper we describe the presentation and management of ductal carcinoma in situ (DCIS) of the breast in women in Australia in 1995. This representative, national data set provides a historical comparator for studies examining DCIS management that follow.
  
  
  METHODS
  Surgeons identified by population-based cancer registries as having treated a new diagnosis of DCIS between 1 April and 30 September 1995 completed a questionnaire on the presentation and management of each case.
  
  
  RESULTS
  Two hundred and five surgeons supplied treatment details on 418 DCIS tumours in 415 women. Half of all tumours were detected at Breast Screen clinics and a further 25% were detected at other mammography centres. Twenty-six percent of tumours were palpable at presentation, 33% were multifocal and 55% were high grade (including comedocarcinoma). Breast conserving therapy (BCT) rather than mastectomy was utilized in 260 (62%)of cases. Tumours that were of low grade, small in size and not multifocal were more likely to be treated by BCT. Surgeons seeing six or moreDCIS cases in the 6-month period were more likely to utilize BCT. Of the conservatively treated cases, 22% were referred for a radiation oncology consultation. The most common reasons for treating DCIS with mastectomy were that the tumour was too extensive or multifocal (63%), it extended to margins of the specimen (42%), or patient concerns about recurrence (34%).
  
  
  CONCLUSIONS
  In 1995 the majority of DCIS was treated with breast conserving surgery alone. Surgeons treating more DCIS cases were more likely to perform conservative surgery than surgeons treating only one DCIS case in the study period.
authors.affiliation: Menzies Centre for Population Health Research, University of Tasmania, Hobart, Tasmania, Australia.
authors.forename: Dace
authors.initials: D
authors.lastname: Shugg
authors.forename: Victoria M
authors.initials: VM
authors.lastname: White
authors.forename: Paul R B
authors.initials: PR
authors.lastname: Kitchen
authors.forename: Myee
authors.initials: M
authors.lastname: Pruden
authors.forename: John P
authors.initials: JP
authors.lastname: Collins
authors.forename: David J
authors.initials: DJ
authors.lastname: Hill
mesh_terms: D000367:Age Factors; D000368:Aged; D001315:Australia; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D003657:Decision Making; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000706:statistics & numerical data; D008327:Mammography; D008408:Mastectomy / Q000706:statistics & numerical data*; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D010818:Practice Patterns, Physicians'; D012111:Residence Characteristics