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A review of autopsy records showed that somewhere between 9% and 15% of women have undetected DCIS at death (Welch, 1997). This supports the idea that a proportion of DCIS occurrences will not progress into invasive cancer or become life-threatening. National Breast Cancer Coalition
Conclusion: “Our systematic review in ten countries over six decades found that incidental detection of cancer in situ and breast cancer precursors is common in women not known to have breast disease during life. The large prevalence pool of undetected cancer in-situ and atypical hyperplasia in these autopsy studies suggests screening programs should be cautious about introducing more sensitive tests that may increase detection of these lesions. – Prevalence of incidental breast cancer and precursor lesions in autopsy studies: a systematic review and meta-analysis
Autopsy studies concluded: A substantial reservoir of DCIS is undetected during life. How hard pathologists look for the disease and, perhaps, their threshold for making the diagnosis are potentially important factors in determining how many cases of DCIS are diagnosed. – Using Autopsy Series To Estimate the Disease “Reservoir” for Ductal Carcinoma in Situ of the Breast: How Much More Breast Cancer Can We Find?
“Autopsy studies have examined the breast tissue of women who had never been diagnosed with breast cancer and found that many cases of DCIS had gone undetected. At least some of the lesions may go away on their own, though it’s not clear how or even whether that happens.” – No Easy Answers
The majority of DCIS lesions found are detected by screening, as many DCIS lesions do not come with symptoms, but do contain calcifications that can be seen upon mammography. Obviously, DCIS lesions may be occult by mammography or the diameter of the area containing calcifications underestimates the extent of DCIS , . This is also illustrated by the much higher prevalence of DCIS (7–39%) found in autopsy studies concerning the age group for which population-based screening programs are in place, whereas in screening and clinical practice (INVASIVE) breast cancer was diagnosed in only 1% of women within a similar age range , . – Finding the balance between over- and under-treatment of ductal carcinoma in situ (DCIS)