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Over time, the proportion of high-grade disease increased (from 60 to 65%), low-grade DCIS decreased (from 10 to 6%) and mean size increased (from 21.4 to 24.1\u2009mm). Mastectomy was more common for high-grade (36%) than for low-grade DCIS (15%). Few (6%) patients treated with breast-conserving surgery (BCS) had a surgical margin &lt;1\u2009mm. Of the 9191 women diagnosed in England (median follow-up 9.4 years), 7% developed DCIS or invasive malignancy in the ipsilateral and 5% in the contralateral breast. The commonest ipsilateral event was invasive carcinoma (<jats:italic>n<\/jats:italic>\u2009=\u2009413), median time 62 months, followed by DCIS (<jats:italic>n<\/jats:italic>\u2009=\u2009225), at median 37 months. Radiotherapy (RT) was most protective against recurrence for high-grade DCIS (3.2% for high-grade DCIS with RT compared to 6.9% without, compared with 2.3 and 3.0%, respectively, for low\/intermediate-grade DCIS). Ipsilateral DCIS events lessened after 5 years, while the risk of ipsilateral invasive cancer remained consistent to beyond 10 years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>DCIS pathology informs patient management and highlights the need for prolonged follow-up of screen-detected DCIS.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41416-020-01152-5","type":"journal-article","created":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T02:02:25Z","timestamp":1605578545000},"page":"1009-1017","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Pathological features of 11,337 patients with primary ductal carcinoma in situ (DCIS) and subsequent events: results from the UK Sloane Project"],"prefix":"10.1038","volume":"124","author":[{"name":"on behalf of the Sloane Project Steering Committee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-8705","authenticated-orcid":false,"given":"Abeer M.","family":"Shaaban","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Hilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Clements","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Provenzano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Cheung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew G.","family":"Wallis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8285-4111","authenticated-orcid":false,"given":"Elinor","family":"Sawyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy S.","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Hanby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4167-8910","authenticated-orcid":false,"given":"Sarah E.","family":"Pinder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair M.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,17]]},"reference":[{"key":"1152_CR1","doi-asserted-by":"publisher","first-page":"1778","DOI":"10.1016\/S0140-6736(12)61611-0","volume":"380","author":"Independent UK Panel on Breast Cancer Screening.","year":"2012","unstructured":"Independent UK Panel on Breast Cancer Screening. 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More recently, the study has been permitted to process personally identifiable data without consent under Regulation 5 of Statutory Instrument 2002 No. 1438: The Health Service (Control of Patient Information) Regulations 2002 (15\/CAG\/0207) in line with the following clause: \u2018quality assuring screening services to ensure they are effective and safe, and that any incidents are investigated and managed appropriately\u2019. This statutory exemption to common law permits Public Health England to process personally identifiable data for activities it is \u2018responsible and accountable to the Secretary of State for Health for\u2019, as part of its core remit for population screening.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors gave consent for publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"Data are held by Public Health England. Access to the Sloane Project data from external parties is governed by consultation with the Sloane Project Steering Group and application to Public Health England\u2019s breast screening research advisory committee (RAC) and Public Health England\u2019s office for data release (ODR). Data will subsequently only be released by Public Health England to researchers under approval and in an anonymised or depersonalised format, with a data sharing contract in place.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This work was supported by Public Heath England and, in part, by Cancer Research UK and by KWF Kankerbestrijding (ref. C38317\/A24043) who provided funding support for K.C., E.S., A.M.T. and S.E.P.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding information"}}]}}