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The primary outcome was ipsilateral breast event, including invasive cancer (iIBC) or DCIS (iDCIS). Fine\u2010Gray subdistributional hazard models assessed associations with demographic and clinical factors, and a 5\u2010year landmark analysis evaluated subsequent risk among women who remained event\u2010free at 5\u2009years. Among 5830 patients (median follow\u2010up 4.8\u2009years), the overall 5\u2010year cumulative risk of iIBC was 3.3% (95% CI: 2.7%, 3.9%). In the 5\u2010year landmark cohort, the subsequent 5\u2010year risk was 4.1% (3.3%, 5.0%). Corresponding iDCIS rates were 2.5% (2.0%, 3.0%) and 1.7% (1.2%, 2.3%), respectively. Age &lt;\u200945\u2009years at diagnosis and DCIS size &gt;\u200920\u2009mm were associated with a higher iIBC risk, but the association with younger age attenuated in the landmark analysis. Compared with breast conserving surgery (BCS) alone, both radiotherapy following BCS and mastectomy were associated with a lower iIBC risk; however, the association for radiotherapy was not evident at the 5\u2010year landmark. Overall, women with DCIS had a 5.25\u2010fold higher risk of invasive breast cancer than the general population (95% CI: 4.79, 5.73). Our findings support the importance of long\u2010term mammographic surveillance, particularly for women with larger DCIS, those treated with BCS, and possibly younger women.<\/jats:p>","DOI":"10.1002\/ijc.70559","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T06:28:49Z","timestamp":1779344929000},"page":"1917-1927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Breast Cancer Outcomes From Ductal Carcinoma In\u00a0Situ: A Population\u2010Based Cohort Study"],"prefix":"10.1002","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4409-9516","authenticated-orcid":false,"given":"Qian","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Elwood","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alana","family":"Cavadino","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyu Sin","family":"Aye","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Medical and Health Sciences University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7303-061X","authenticated-orcid":false,"given":"Sandar","family":"Tin Tin","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit, Oxford Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2016161174"},{"key":"e_1_2_12_3_1","volume-title":"Management of Early Breast Cancer","author":"New Zealand Guidelines Group","year":"2009"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2024.0035"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2025.104521"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znaf045"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1570"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-075498"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076022"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5249-5"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgq039"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.49.5077"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.56.2595"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-019-05377-8"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-021-01496-6"},{"key":"e_1_2_12_16_1","unstructured":"\u201cCancer Web Tool \u201d 2023 https:\/\/tewhatuora.shinyapps.io\/cancer\u2010web\u2010tool\/."},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.26635\/6965.6229"},{"key":"e_1_2_12_18_1","unstructured":"Breast Cancer Foundation NZ \u201c30 000 Voices: Informing a Better Future for Breast Cancer in Aotearoa New Zealand \u201d 2022 https:\/\/breastcancerregister.org.nz\/images\/assets\/4744\/1\/breast%20cancer%20foundation%20national%20register%20report%202022%20final.pdf."},{"key":"e_1_2_12_19_1","unstructured":"National Screening Unit Te Whatu Ora Wellington \u201cNew Breast Cancer Diagnoses and Treatments 2020 \u201d 2023."},{"key":"e_1_2_12_20_1","volume-title":"NZDep2018 Index of Deprivation, Final Research Report, December 2020","author":"Atkinson J. 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