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Challenges in ductal carcinoma in situ risk communication and decision-making†

Report from an American Cancer Society and National Cancer Institute Workshop

  1. Ann H. Partridge MD, MPH1,*,
  2. Joann G. Elmore MD, MPH2,
  3. Debbie Saslow PhD3,
  4. Worta McCaskill-Stevens MD, MS4,
  5. Stuart J. Schnitt MD5

Article first published online: 4 APR 2012

DOI: 10.3322/caac.21140

Issue

CA: A Cancer Journal for Clinicians

CA: A Cancer Journal for Clinicians

Volume 62, Issue 3, pages 203–210, May/June 2012

Additional Information

How to Cite

Partridge, A. H., Elmore, J. G., Saslow, D., McCaskill-Stevens, W. and Schnitt, S. J. (2012), Challenges in ductal carcinoma in situ risk communication and decision-making. CA: A Cancer Journal for Clinicians, 62: 203–210. doi: 10.3322/caac.21140

Author Information

  1. 1

    Associate Professor, Department of Medicine, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA

  2. 2

    Professor of Medicine, Adjunct Professor of Epidemiology, University of Washington School of Medicine, Section Head of General Medicine, Harborview Medical Center, Seattle, WA

  3. 3

    Director of Breast and Gynecologic Cancer, American Cancer Society, Atlanta, GA

  4. 4

    Program Director, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD

  5. 5

    Director, Anatomic Pathology, Beth Israel Deaconess Medical Center, Professor, Department of Pathology, Harvard Medical School, Boston, MA

*Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215

  1. †

    DISCLOSURES: Dr. Elmore serves as a medical editor for the nonprofit Foundation for Informed Medical Decision Making.

Publication History

  1. Issue published online: 7 MAY 2012
  2. Article first published online: 4 APR 2012

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Abstract

In September 2010, the American Cancer Society and National Cancer Institute convened a conference to review current issues in ductal carcinoma in situ (DCIS) risk communication and decision-making and to identify directions for future research. Specific topics included patient and health care provider knowledge and attitudes about DCIS and its treatment, how to explain DCIS to patients given the heterogeneity of the disease, consideration of nomenclature changes, and the usefulness of decision tools/aids. This report describes the proceedings of the workshop in the context of the current literature and discusses future directions. Evidence suggests that there is a lack of clarity about the implications and risks of a diagnosis of DCIS among patients, providers, and researchers. Research is needed to understand better the biology and mechanisms of the progression of DCIS to invasive breast cancer and the factors that predict those subtypes of DCIS that do not progress, as well as efforts to improve the communication and informed decision-making surrounding DCIS. CA Cancer J Clin 2012. © 2012 American Cancer Society.

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