{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:52:56Z","timestamp":1761519176133,"version":"build-2065373602"},"reference-count":46,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2016,5,31]],"date-time":"2016-05-31T00:00:00Z","timestamp":1464652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Institutes of Health\/National Cancer Institute","award":["U54 CA163303","R01 CA067264","P30 CA014520"],"award-info":[{"award-number":["U54 CA163303","R01 CA067264","P30 CA014520"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2016,9,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The use of surgery and radiation therapy in treating ductal carcinoma in situ (DCIS) is directed by treatment guidelines and evidence from research. This study investigated recent patterns in DCIS treatment by demographic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Data for women diagnosed with DCIS between 1998 and 2011 (n = 416,232) in the National Cancer Data Base were assessed for trends in treatment patterns by age group, calendar year, ancestral\/ethnic group, and geographic region. The likelihood of receiving specific treatment modalities was analyzed with multivariable logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>DCIS cases were most frequently treated with breast\u2010conserving surgery (BCS) and adjuvant radiation (45.6%). After an initial rise, the use of adjuvant radiation after BCS plateaued at approximately 70% after 2007, with increasing utilization of mastectomy beyond 2005. In addition, there was an increasing trend in postmastectomy reconstruction over time, and women of African ancestry (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.66\u20100.72) and Hispanic women (OR, 0.83; 95% CI, 0.78\u20100.89) were less likely to undergo reconstruction in comparison with women of European ancestry. A similar trend was observed in contralateral risk\u2010reducing mastectomy utilization, with women of European ancestry having a more rapid rise in the utilization of contralateral risk\u2010reducing mastectomy in comparison with all other ancestral\/ethnic groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Recent trends demonstrate a plateau in radiation therapy administration after BCS along with increasing utilization of mastectomy, reconstruction, and contralateral risk\u2010reducing mastectomy. There are substantial differences in treatment utilization according to ancestry\/ethnicity and geographical region. Further studies examining patient\u2010physician decision making surrounding DCIS treatment are warranted. <jats:bold><jats:italic>Cancer<\/jats:italic> 2016<\/jats:bold>. \u00a9 <jats:italic>2016 American Cancer Society<\/jats:italic>. <jats:italic><jats:bold>Cancer 2016;122:2810\u20132818.<\/jats:bold> \u00a9 2016 American Cancer Society<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30105","type":"journal-article","created":{"date-parts":[[2016,5,31]],"date-time":"2016-05-31T11:16:52Z","timestamp":1464693412000},"page":"2810-2818","source":"Crossref","is-referenced-by-count":19,"title":["Emerging trends in surgical and adjuvant radiation therapies among women diagnosed with ductal carcinoma in situ"],"prefix":"10.1002","volume":"122","author":[{"given":"Oyewale O.","family":"Shiyanbola","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences and Carbone Cancer Center University of Wisconsin\u2013Madison Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian L.","family":"Sprague","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Vermont Burlington Vermont"},{"name":"University of Vermont Cancer Center Burlington Vermont"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Hampton","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences and Carbone Cancer Center University of Wisconsin\u2013Madison Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Dittus","sequence":"additional","affiliation":[{"name":"University of Vermont Cancer Center Burlington Vermont"},{"name":"Department of Medicine University of Vermont Burlington Vermont"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ted A.","family":"James","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Vermont Burlington Vermont"},{"name":"University of Vermont Cancer Center Burlington Vermont"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Herschorn","sequence":"additional","affiliation":[{"name":"University of Vermont Cancer Center Burlington Vermont"},{"name":"Department of Radiology University of Vermont Burlington Vermont"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald E.","family":"Gangnon","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences and Carbone Cancer Center University of Wisconsin\u2013Madison Madison Wisconsin"},{"name":"Department of Biostatistics and Medical Informatics University of Wisconsin\u2013Madison Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald L.","family":"Weaver","sequence":"additional","affiliation":[{"name":"University of Vermont Cancer Center Burlington Vermont"},{"name":"Department of Pathology and Laboratory Medicine University of Vermont Burlington Vermont"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Trentham\u2010Dietz","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences and Carbone Cancer Center University of Wisconsin\u2013Madison Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,31]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"1","article-title":"NIH state\u2010of\u2010the\u2010science conference statement: diagnosis and management of ductal carcinoma in situ (DCIS)","volume":"26","author":"Allegra CJ","year":"2009","journal-title":"NIH Consens State Sci Statements."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-143-6-200509200-00009"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1093\/jncimono\/1997.22.151","article-title":"Increases in ductal carcinoma in situ (DCIS) of the breast in relation to mammography: a dilemma","volume":"1997","author":"Ernster VL","year":"1997","journal-title":"J Natl Cancer Inst Monogr."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djp482"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.7.953"},{"key":"e_1_2_8_7_1","unstructured":"National Comprehensive Cancer Network.Breast cancer: NCCN guidelines for patients version 2.2011.http:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/breast.pdf. 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