Background The incidence of breast carcinoma in situ has increased at a fast rate. Most clinical series have focused on cancer recurrence, rather than risk of death per se. Aim of this study was to assess the incidence and treatment in the Netherlands and estimate the excess mortality risk of carcinoma in situ.
Methods From the Netherlands Cancer Registry, adult females with carcinoma in situ were selected. Treatment was assessed according to age. Relative mortality at 10 years of follow-up was calculated by dividing observed mortality over expected mortality and stratified for age and treatment. Expected mortality was calculated using the Dutch general population matched by age and year.
Results Overall, 8879 patients were included in this study. For patients aged 50–64 and 65–74 an increase in breast conserving surgery was observed over time (p<0.001). For patients over 75 years of age, 8.0% did not undergo surgery. For all ages adjuvant radiotherapy after breast conserving surgery increased. For patients who received no surgery, observed mortality exceeded expected mortality in all ages (excess ratio ranged from 2.5 to 8.7). Overall, treated patients aged 50 years and older experienced no excess mortality due to carcinoma in situ regardless of treatment (ratio of 1.0, 0.96 and 1.0, respectively).
Conclusion The present population-based study of almost 9000 patients showed no excess mortality in surgically treated women over 50 years with carcinoma in situ. The estimated risk of death from breast cancer within 10 years following diagnosis was low with every (surgical) treatment option.
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