Two Decades of Experience with Ductal Carcinoma in Situ of the Breast in the Cancer Institute of Tehran,Iran

Background: Breast cancer screening and higher quality mammography have resulted in an increase in thediagnosis of ductal carcinoma in situ worldwide. We compared the incidence and other factors in our cases ofductal carcinoma in situ between two recent decades. Materials and Methods: Medical records of cases of ductalcarcinoma in situ who had been admitted to the surgery wards of the Cancer Institute of Tehran, Iran wereevaluated from March 1993 to March 2003 as phase 1, and from April 2003 to April 2013 as phase 2. Results:Ratio of ductal carcinoma in situ to overall breast cancer was 1.27 and 3.93 in phases 1 and 2, respectively. Ratesof excisional or incisional biopsies versus core needle biopsies and clinically versus mammographically detectedcases as well as median size of tumors dropped between the 2 phases while a substantial rise in the numberof patients attending for screening was seen in this time period. Surgical treatments followed a trend frommodified radical mastectomy and axillary lymphatic dissection toward breast conserving surgery and sentinelnode dissection or no axillary intervention. Conclusions: Our study shows a considerable trend toward earlierdetection of breast cancer and evolution of treatment strategies toward standard less invasive surgery of DCISin Iran.