title: Ductal carcinoma in situ in the Department of Defense.
abstract: OBJECTIVE
  Our objective is to investigate some of the trends and variables within the ductal carcinoma in situ (DCIS) diagnosed population and to compare them with the greater civilian populations to identify any possible areas of deficiency or superiority in comparison with civilian institutions.
  
  
  METHODS
  A retrospective analysis of 5023 patients.
  
  
  METHODS
  81st Medical Group Clinical Research Laboratory at Keesler AFB, Mississippi.
  
  
  METHODS
  All patients treated for ductal carcinoma in situ entered into the Automated Central Tumor Registry (ACTUR) between January 1988 and December 2009.
  
  
  RESULTS
  Overall, the rate of finding invasive components after surgery for suspected DCIS was 8.6% (95% confidence interval [CI] = 7.79-9.33). Compared with other published rates, the military has a statistically significant lower rate (p < 0.001). From age 25 until age 65, there is a significant negative correlation of finding invasive cancer after treatment for DCIS (Spearman Rank Correlation = -0.051, p = 0.001). No statistically significant correlations were found between tumor size or grade and finding an invasive component.
  
  
  CONCLUSIONS
  The military medical system has provided a reduced probability of finding invasive cancer after treatment for DCIS compared to civilian institutions. Reduced physician workload, patient proactiveness, and public health involvement are among the likely factors.
authors.affiliation: Department of Surgery, Keesler Medical Center, Keesler Air Force Base, MS 39534, USA. andrew.hall.2@us.af.mil
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Hall
authors.forename: Walter
authors.initials: W
authors.lastname: Brehm
authors.forename: Heather K
authors.initials: HK
authors.lastname: Bright
authors.forename: Shea
authors.initials: S
authors.lastname: Pribyl
authors.forename: Byron E
authors.initials: BE
authors.lastname: Hall
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000453:epidemiology* / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D008887:Military Medicine; D008889:Military Personnel; D008922:Mississippi / Q000453:epidemiology; D012189:Retrospective Studies