Ductal carcinoma in situ (DCIS): the role of prognostic indicators in informing treatment and reducing local recurrence

A retrospective study of cases of DCIS diagnosed in the West Midlands during the period 1 April 1988–31 March 1999 was undertaken. Of the 840 cases diagnosed, full pathology and treatment information was available for 586 cases. Following exclusions a retrospective radiological review was completed on 519 of these cases. Follow-up data were attained for a maximum of 14 years and a minimum of 3 years.

Radiological characteristics were aligned with well-accepted pathological prognostic indicators to provide a preoperative radiological index. Analyses of operation type and local recurrence rates were undertaken.

The correlation between radiological and pathological size was evaluated and it was noted that pathology consistently 'underestimated' the size of the radiologically more extensive tumours. There was good correlation with tumour grade and calcification type, with 53% of high grade tumours displaying casting calcifications.

The dataset indicates that there may be a possible role of preoperative radiological characteristics for providing information previously only available postoperatively to aid management decisions. A greater number of cases would be required to establish this coherently. It is hoped that the Sloane Project will be able to answer these questions.