• Bruno Cutuli, Claire Lemanski, Brigitte De Lafontan, Marie-Pierre Chauvet, De LaraChristine TunonCTDepartment of Surgical Oncology, Institut Bergonié, Bordeaux, France., Alice Mege, Daniele Fric, Marion Richard-Molard, Chafica Mazouni, Caroline Cuvier, Agnes Carre, and Youla Kirova.
• Department of Radiation Oncology, Institut du Cancer Courlancy, Reims, France. Electronic address: bcutuli@iccreims.fr.
• Clin. Breast Cancer. 2020 Apr 1; 20 (2): e164-e172.

BackgroundDuctal carcinoma in situ (DCIS) represents 15% of all breast cancers in France. The first national survey was conducted in 2003. The present multi-center real-life practice survey aimed at assessing possible changes in demographic, clinical, pathologic, and treatment features.Material And MethodsFrom March 2014 to September 2015, patients diagnosed with DCIS from 71 centers with complete information about age, diagnostic features, and treatment modalities were prospectively included.ResultsA total of 2125 patients with a median age of 58.6 years from 71 centers were studied. DCIS was diagnosed by mammography in 87.5% of cases. Preoperative biopsy was performed in 96% of cases. The median tumor size was 15 mm. Nuclear grade was low, intermediate, and high in 12%, 36%, and 47% of cases, respectively. Margins were considered to be negative in 83% of cases. Overall mastectomy and lumpectomy rates were 25% and 75%, respectively. The immediate breast reconstruction rate was 50%. Sentinel node biopsy and axillary dissection rates were 41% and 2.6%, respectively. After lumpectomy, 97% of patients underwent radiotherapy, and 32% received a boost dose. Only 1% of patients received endocrine therapy. Compared with our previous survey, the median tumor size remained the same, and the proportion of high-grade lesions increased by 9%. The mastectomy rate decreased by 4%.ConclusionsThe clinical practice identified in this survey complies with French DCIS guidelines. About 10% of patients with low-grade DCIS may be eligible to participate in treatment de-escalation trials.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

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