Perceptions and management approaches of physicians who care for women with ductal carcinoma in situ

Clin Breast Cancer. 2008 Jun;8(3):275-80. doi: 10.3816/CBC.2008.n.032.


Purpose: Limited previous data suggest that heterogeneity exists in the treatment approaches for women with ductal carcinoma in situ (DCIS). We sought in a longitudinal cohort study of women with DCIS to assess the attitudes and management approaches toward DCIS among physicians who provide care to women.

Materials and methods: Eligible physicians were invited to participate in a 1-time mailed survey. A financial incentive and reminders were used to enhance the response rate. Physician perception of risks associated with DCIS for patients and management approaches were evaluated.

Results: Two hundred and eight physicians were identified, and 151 (73%) completed the survey. Respondents had a median age of 49 years (range, 32-75 years), and most were surgeons or medical oncologists (66%). Eighty-eight percent reported seeing an average of >or= 1 new patient with DCIS per month. In a multivariable model, physicians who cared for proportionately fewer patients with breast cancer were more likely to view DCIS as a riskier disease to a patient's overall health compared with physicians who cared for more women with breast cancer (odds ratio, 2.2; 95% CI, 1.1-4.6; P = .036). Physicians exhibited differences in management approaches when considering theoretical patients with DCIS and did not use consistent terms when speaking with patients with DCIS.

Conclusion: Substantial variation exists among physicians regarding perceptions and management approaches for women with DCIS. In some settings, risks of physician-recommended therapy might outweigh benefits. Further evaluation of the effects of physician management approaches and attitudes about DCIS on patient outcomes is warranted.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel
  • Breast Neoplasms / therapy*
  • Carcinoma in Situ / therapy*
  • Carcinoma, Ductal, Breast / therapy*
  • Cohort Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Perception
  • Physicians