Ductal carcinoma in situ (DCIS): a French National Survey. Analysis of 2,125 patients.

ABSTRACT Purpose Ductal carcinoma in situ (DCIS) represents 15% of all breast cancers in France. A first national survey was conducted in 2003. The present multicentre real-life practice survey aimed at assessing possible changes in demographic, clinical, pathological and treatment features. Material And Methods From March 2014 to September 2015, patients diagnosed with DCIS from 71 centres with complete information about age, diagnostic features and treatment modalities were prospectively included. Results A total of 2,125 patients with a median age of 58.6 years from 71 centres were studied.. DCIS was diagnosed by mammography in 87.5% of cases. Preoperative biopsy was performed in 96% of cases. Median tumour size was 15 mm. Nuclear grade was low, intermediate and high in 12%, 36% and 47% of cases, respectively. Margins were considered to be negative in 83% of cases. Overall mastectomy and lumpectomy rates were 25% and 75%, respectively. The immediate breast reconstruction rate was 50%. Sentinel node biopsy and axillary dissection (AD) rates were 41% and 2.6%, respectively. After lumpectomy, 97% of patients underwent radiotherapy and 32% received a boost dose. Only 1% of patients received endocrine therapy. Compared to our previous survey, median tumour size remained the same and the proportion of high-grade lesions increased by 9%. The mastectomy rate decreased by 4%. Conclusions The clinical practice identified in this survey complies with French DCIS guidelines. About 10% of patients with low-grade DCIS may be eligible to participate in treatment de-escalation trials.