Should breast screening programmes limit their detection of ductal carcinoma in situ?.
OBJECTIVE: Previous research has shown that the detection of ductal carcinoma in situ (DCIS) aids the detection of small invasive cancers at mammographic screening. A correlation may therefore exist between a screening unit’s DCIS detection rate and their small invasive cancer detection rate. We have therefore investigated the effect of DCIS detection rate on the detection of small (<15 mm) invasive cancers in the 95 units of the U.K. NHS Breast Screening Programme (NHSBSP). MATERIALS AND METHODS: DCIS detection rates were examined against large (> or =15 mm) and small (<15 mm) invasive cancer detection rates in women aged 50-64 years at prevalent and incident screens over a 3-year period. RESULTS: After adjusting for background incidence, screening units with the highest DCIS detection of > or =1.3/1000 detected over 20% more small invasive cancers than units with DCIS detection rates within the NHSBSP guidelines of 0.5-1/1000 (P<0.001). Sixty percent of units had DCIS detection rates
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