Epidemiology of Ductal Carcinoma In Situ

• One in eight women (i.e., 12% to 13%) in the United States (US):
  • Will be diagnosed with breast cancer in there lifetime:
    • 20% to 25% of these newly diagnosed cases are DCIS
• In 2022:
  • An estimated 287,850 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S.:
    • Along with 51,400 new cases of non-invasive (in situ) breast cancer
  • About 43,250 women in the U.S. are expected to die in 2022 from breast cancer:
    • Death rates have been steady in women under 50 since 2007:
      • But have continued to drop in women over 50
    • The overall death rate from breast cancer:
      • Decreased by 1% per year from 2013 to 2018
    • These decreases are thought to be the result of:
      • Treatment advances and earlier detection through screening
    • For women in the U.S., breast cancer death rates are higher than those for any other cancer:
      • Besides lung cancer
• As of January 2022:
  • There are more than 3.8 million women with a history of breast cancer in the U.S:
    • This includes women currently being treated and women who have finished treatment
• Breast cancer is the most commonly diagnosed cancer among American women:
  • In 2022, it’s estimated that about 30% of newly diagnosed cancers in women:
    • Will be breast cancers
• Breast cancer became the most common cancer globally as of 2021:
  • Accounting for 12% of all new annual cancer cases worldwide:
    • According to the World Health Organization
• In women under 45:
  • Breast cancer is more common in Black women than white women
• Overall, Black women:
  • Are more likely to die of breast cancer
• For Asian, Hispanic, and Native-American women:
  • The risk of developing and dying from breast cancer is lower
• Ashkenazi Jewish women have a higher risk of breast cancer:
  • Because of a higher rate of BRCA mutations
• Widespread use of screening mammography:
  • Has resulted in a 10-fold increase in the reported incidence of DCIS since the mid-1980s:
    • But since 2003:
      • The incidence of DCIS has declined in women age 50 years and older:
        • Possibly due to decreased use of hormone replacement therapy
      • While the incidence in women under 50 continues to increase
  • Approximately 1 in every 1,300 mammography examinations performed in US:
    • Will lead to a diagnosis of DCIS:
      • Representing 17% to 34% of all mammographically detected breast cancers
  • Before the introduction of screening mammography:
    • Most cases of DCIS were not detected until a palpable mass formed:
      • But today, 80% to 85% of DCIS cases are screen detected
• The incidence of DCIS in autopsy studies is higher than in the general population:
  • Suggesting that not all DCIS lesions become clinically significant and supporting concerns that most of the increase in DCIS incidence is due to the detection of nonaggressive subtypes that are unlikely to progress to invasive cancer
• The median age reported for patients with DCIS ranges from:
  • 47 to 63 years:
    • Similar to that reported for patients with invasive carcinoma:
      • However, the age of peak incidence for DCIS:
        • 96.7 per 100,000 women – occurs between the ages of 65 and 69 years:
          • Which is younger than that for invasive breast cancer, for which peak incidence 453.1 per 100,000 women – occurs between the ages of 75 and 79 years
• The frequency of first-degree relatives having breast cancer (i.e., 10% to 35%) as well as rates of deleterious mutations in the breast cancer–associated (BRCA) genes:
  • Are the same for patients with DCIS as for women with invasive breast malignancies
• Other risk factors for DCIS including:
  • Older age
  • Proliferative breast disease
  • Increased breast density
  • Nulliparity
  • Older age at primiparity
  • History of breast biopsy
  • Early menarche
  • Late menopause
  • Long-term use of postmenopausal hormone replacement therapy
  • Elevated body mass index in postmenopausal women:
    • Are the same as those for invasive breast cancer, but in many instances:
      • The association between a given characteristic and invasive cancer is stronger than the association between that characteristic and DCIS

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