Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Women’s views about current and future management of Ductal Carcinoma in Situ (DCIS): a mixed-methods study (#258)

Jolyn Hersch 1 2 , Brooke Nickel 1 2 , Jesse Jansen 3 , Alexandra Barratt 2 , Nehmat Houssami 4 , Christobel Saunders 5 , Andrew Spillane 6 , Claudia Rutherford 4 , Kirsty Stuart 7 , Geraldine Robertson 8 , Ann Dixon 9 , Kirsten McCaffery 1 2
  1. Sydney Health Literacy Lab (SHeLL), School of Public Health, The University of Sydney, Sydney, NSW, Australia
  2. Wiser Healthcare, Sydney, NSW, Australia
  3. CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
  4. The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, NSW, Australia
  5. Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
  6. Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
  7. Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
  8. Breast Cancer Network Australia, Melbourne, VIC, Australia
  9. Sydney Neuropsychology Clinic, School of Psychology, The University of Sydney, Sydney, NSW, Australia

Aims: Management of low-risk ductal carcinoma in situ (DCIS) is controversial, with clinical trials currently assessing the safety of active monitoring amidst concern about overtreatment. Little is known about general community views regarding DCIS and its management. We aimed to explore women’s understanding and views about low-risk DCIS and current and potential future management options.

 

Methods: This mixed-method study involved qualitative focus groups and brief quantitative questionnaires. Participants were screening-aged (50–74 years) women, with diverse socioeconomic backgrounds and no personal history of breast cancer/DCIS, recruited from across metropolitan Sydney, Australia. Sessions incorporated an informative presentation interspersed with group discussions which were audio recorded, transcribed and analysed thematically.

 

Results: Fifty-six women took part in six age-stratified focus groups. Prior awareness of DCIS was limited, however women developed reasonable understanding of DCIS and the relevant issues. Overall, women expressed substantial support for active monitoring being offered as a management approach for low-risk DCIS, and many were interested in participating in a hypothetical clinical trial. Although some women expressed concern that current management may sometimes represent overtreatment, there were mixed views about personally accepting monitoring. Women noted several important questions and considerations that would factor into their decision making.

 

Conclusions: Our findings about women’s perceptions of active monitoring for DCIS are timely while results of ongoing clinical trials of monitoring are awaited, and may inform clinicians and investigators designing future, similar trials. Exploration of offering well-informed patients the choice of non-surgical management of low-risk DCIS, even outside a clinical trial setting, may be warranted.