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A Comparison of Risk Perception and Psychological Morbidity in Women with Ductal Carcinoma in situ and Early Invasive Breast Cancer

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Abstract

Purpose. To assess how women with ductal carcinoma in situ (DCIS) perceive their risks of recurrence, dying from breast cancer, and psychological distress compared to women with early stage invasive breast cancer (EIBC).

Patients and methods. Eligible patients included those with DCIS or EIBC (T1 or T2, N0) referred to one cancer center between November 1998 and June 1999. Participants completed a self-administered survey regarding their views of their risks of developing recurrent cancer, of dying of breast cancer and the presence of psychological symptoms of distress. Responses were scored and compared between the two groups.

Results. In total, 495 patients were screened, 240 found ineligible, 228 patients who agreed to participate. No significant difference between the two groups was observed in perceptions of risk related to the likelihood of developing local recurrence (DCIS: 53%, EIBC 45%, P = 0.14), distant recurrence (DCIS: 36%; EIBC: 39%, P = 0.35) or dying of breast cancer (DCIS: 27%, EIBC 27%, P = 0.5). Both groups expressed similar levels of psychological distress (anxiety, DCIS: 56%, EIBC 54%, P = 0.38; depression, DCIS: 41%, EIBC, 48%, P = 0.17).

Conclusions. Despite the excellent prognosis, women with DCIS express serious concerns and report similar psychological morbidity as women with invasive cancer.

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References

  1. Ernster VL, Barclay J: Increases in ductal carcinoma in situ (DCIS) of the breast in relation to mammography: a dilemma [Review] [34 Refs.]. J Natl Cancer Inst Monogr 151: 6, 1997

    Google Scholar 

  2. Baum M: Patients' perception of risk and breast cancer awareness. Br J Radiol 70: 777-781, 1997

    Google Scholar 

  3. Ernster VL, Barclay J, Kerlikowske K, Grady D, Henderson C: Incidence of and treatment for ductal carcinoma in situ of the breast. JAMA 275: 913-918, 1996

    Google Scholar 

  4. Ernster VL, Barclay J, Kerlikowske K, Wilkie H, Ballard-Barbash R: Mortality among women with ductal carcinoma in situ of the breast in the population-based surveillance, epidemiology and end results program. Arch Internal Med 160: 953-958, 2000

    Google Scholar 

  5. Alpers CE, Wellings SR: The prevalence of carcinoma in situ in normal and cancer-associated breasts. Human Pathol 16: 796-807, 1985

    Google Scholar 

  6. Bartow SA, Pathak DR, Black WC, Key CR, Teaf SR: Prevalence of benign, atypical, and malignant breast lesions in populations at different risk for breast cancer. A forensic autopsy study. Cancer 60: 2751-2760, 1900

    Google Scholar 

  7. Bhathal PS, Brown RW, Lesueur GC, Russell IS: Frequency of benign and malignant breast lesions in 207 consecutive autopsies in Australian women. Br J Cancer 51: 271-278, 1985

    Google Scholar 

  8. Kramer WM, Rush Jr BF: Mammary duct proliferation in the elderly. Cancer 31: 130-137, 1973

    Google Scholar 

  9. Nielsen M, Jensen J, Andersen J: Precancerous and cancerous breast lesions during lifetime and at autopsy. A study of 83 women. Cancer 54: 612-615, 1984

    Google Scholar 

  10. Nielsen M, Thomsen JL, Primdahl S, Dyreborg U, Andersen JA: Breast cancer and atypia among young and middle-aged women: a study of 110 medicolegal autopsies. Br J Cancer 56: 814-819, 1987

    Google Scholar 

  11. Wellings SR, Jensen HM: On the origin and progression of ductal carcinoma in the human breast. J Natl Cancer Inst 50: 1111-1118, 1973

    Google Scholar 

  12. Fowble B, Hanlon AL, Fein DA, Hoffman JP, Sigurdson ER, Patchefsky A, Kessler H: Results of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS). Int J Radiat Oncol, Biol, Phy 38: 949-957, 1997

    Google Scholar 

  13. Silverstein MJ, Lagios MD: Use of predictors of recurrence to plan therapy for DCIS of the breast [Review] [74 Refs.]. Oncology 1: 393-406, 1997

    Google Scholar 

  14. Silverstein MJ: Van Nuys experience by treatment. In: Silverstein MJ (ed). Ductal Carcinoma In Situ. Williams &; Wilkins, Baltimore, 1997, pp 443-447

    Google Scholar 

  15. Solin LJ, Kurtz J, Fourquet A, Amalric R, Recht A, Bornstein BA, Kuske R, Taylor M, Barrett W, Fowble B, Haffty B, Schultz, DJ, Yeh IT, McCormick B, McNeese M: Fifteenyear results of breast-conserving surgery and definitive breast irradiation for the treatment of ductal carcinoma in situ of the breast. J Clin Oncol 14: 754-763, 1996

    Google Scholar 

  16. Anonymous: Tamoxifen for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists' Collaborative Group. Lancet351: 1451-1467, 1998

  17. Anonymous: Polychemotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists' Collaborative Group. Lancet 19(352): 930-942, 1998

    Google Scholar 

  18. Clark RM, Whelan T, Levine M, Roberts R, Willan A, McCulloch P, Roberts R, Willan A, McCulloch P, Lipa M, Wilkinson RH, Mahoney LJ: Randomized clinical trial of breast irradiation following lumpectomy and axillary dissection for node-negative breast cancer: an update. Ontario Clinical Oncology Group. J Natl Cancer Inst 88: 1659-1664, 1996

    Google Scholar 

  19. Fisher B, Redmond C, Poisson R, Margolese R, Wolmark N, Wickerham L, Fisher E, Deutsch M, Caplan R, Pitch Y: Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer [published erratum appears in N Engl J Med 330(20): 1467, 1994]. N Engl J Med 320(13): 822-828, 1989

    Google Scholar 

  20. Fisher B, Costantino J, Redmond C, Fisher E, Margolese R, Dimitrov N, Wolmark N, Wickerham DL, Deutsch M, Ore L: Lumpectomy compared with lumpectomy and radiation therapy for the treatment of intraductal breast cancer. N Engl J Med 328: 1581-1586, 1993

    Google Scholar 

  21. Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM: Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 1333: 1456-1461, 1995

    Google Scholar 

  22. Fisher B, Dignam J, Wolmark N, Wickerham DL, Fisher ER, Mamounas E, Smith R, Begovic M, Dimitrov NV, Margolese RG, Kardinal CG, Kavanah MT, Fehrenbacher L, Oishi RH: Tamoxifen in treatment of intraductal breast cancer: National Surgical Adjuvant Breast and Bowel Project B-24 randomised controlled trial. Lancet 353: 1993-2000, 1999

    Google Scholar 

  23. Jacobson JA, Danforth DN, Cowan KH, d'Angelo T, Steinberg SM, Pierce L, Lippman ME, Lichter AS, Glatstein E, Okunieff P: Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. N Engl J Med 332: 907-911, 1995

    Google Scholar 

  24. Amichetti M, Caffo O, Arcicasa M, Roncadin M, Lora O, Rigon A, Zini G, Armaroli L, Coghetto F, Zorat P, Neri S, Teodorani N: Quality of life in patients with ductal carcinoma in situ of the breast treated with conservative surgery and postoperative irradiation. Breast Cancer Res Treat 54: 109-115, 1999

    Google Scholar 

  25. Aiken LA, Fenaughty AM, West SG, Johnson JJ, Luckett TL: Perceived determinants of risk for breast cancer and the relations among objective risk, perceiver, and screening behavior over time. Womens Health 1(1): 27-50, 1995

    Google Scholar 

  26. Black WC, Nease RFJ, Tosteson AN: Perceptions of breast cancer risk and screening effectiveness in women younger than 50 years of age (see comments). J Natl Cancer Inst 87: 720-731, 1995

    Google Scholar 

  27. Recht A, Rutgers EJ, Fentiman IS, Kurtz JM, Mansel RE, Sloane JP: The Fourth EORTC DCIS Consensus Meeting (Chateau Marquette, Heemskerk, The Netherlands, 23-24 January 1998)-Conference Report [Review] [42 Refs.]. Eur J Cancer 34: 1664-1669, 1998

    Google Scholar 

  28. Steering Committee on Clinical Practice Guidelines for the Care and Treatment of Breast Cancer. The management of ductal carcinoma in situ (DCIS). Can Med Assoc J 158(Suppl 3): S27-S34, 1998

    Google Scholar 

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Authors and Affiliations

  1. Department of Radiation Oncology, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada

    Eileen Rakovitch, Ida Ackerman, Jean-Philippe Pignol & Lawrence Paszat

  2. Clinical Epidemiology Unit, Sunnybrook & Women's Health Science Centre, Toronto, Ontario, Canada

    Edmee Franssen & Cindy Ho

  3. Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada

    John Kim

  4. Department of Medical Oncology, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada

    Kathleen I. Pritchard

  5. Department of Medicine, Sunnybrook & Women's Health Science Centre, Toronto, Ontario, Canada

    Donald A. Redelmeier

Authors
  1. Eileen Rakovitch
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  2. Edmee Franssen
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  3. John Kim
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  4. Ida Ackerman
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  5. Jean-Philippe Pignol
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  6. Lawrence Paszat
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  7. Kathleen I. Pritchard
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  8. Cindy Ho
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  9. Donald A. Redelmeier
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Rakovitch, E., Franssen, E., Kim, J. et al. A Comparison of Risk Perception and Psychological Morbidity in Women with Ductal Carcinoma in situ and Early Invasive Breast Cancer. Breast Cancer Res Treat 77, 285–293 (2003). https://doi.org/10.1023/A:1021853302033

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  • DOI: https://doi.org/10.1023/A:1021853302033

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