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Breast Cancer Outcomes From Ductal Carcinoma In Situ: A Population-Based Cohort Study
Qian Chen1, Ian Campbell2, Mark Elwood1
1Department of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
International Journal of Cancer
|May 21, 2026
Summary
Women diagnosed with ductal carcinoma in situ (DCIS) face a significantly higher risk of subsequent invasive breast cancer. Long-term mammographic surveillance is crucial, especially for those with larger DCIS or treated with breast conserving surgery.
Area of Science:
- Oncology
- Epidemiology
- Public Health
Background:
- Ductal carcinoma in situ (DCIS) is a non-invasive breast condition.
- Understanding the subsequent risk of invasive breast cancer after DCIS is critical for patient management and surveillance strategies.
Purpose of the Study:
- To investigate changes in the subsequent risk of breast cancer after DCIS over time in New Zealand women.
- To identify demographic and clinical factors associated with an increased risk of ipsilateral invasive breast cancer (iIBC) or DCIS (iDCIS) after an initial DCIS diagnosis.
Main Methods:
- Population-based cohort study using data from the New Zealand Breast Cancer Foundation National Register (2000-2022).
- Fine-Gray subdistributional hazard models were used to assess risk factors.
- A 5-year landmark analysis evaluated subsequent risk in women event-free at 5 years.
Main Results:
- The 5-year cumulative risk of iIBC after DCIS was 3.3%, and the subsequent 5-year risk in the landmark cohort was 4.1%.
- Age under 45 and DCIS size over 20 mm were associated with higher iIBC risk.
- Women with DCIS had a 5.25-fold higher risk of invasive breast cancer compared to the general population.
Conclusions:
- Women with DCIS have a substantially elevated long-term risk of developing invasive breast cancer.
- Long-term mammographic surveillance is recommended, particularly for younger women, those with larger DCIS, and those treated with breast conserving surgery.
