Since the introduction of digital population-based breast cancer screening, a dramatic increase in the incidence of DCIS has been observed. While currently the standard care is breast surgery (e.g., mastectomy, or wide local excision with or without radiotherapy), increasing evidence suggests that low graded DCIS can be managed by active surveillance. However, it is yet unknown what patient preferences regarding the ‘treatment’ of low-grade DCIS are, and how patients balance the pros and cons of the mental (worries, risks, and fears) and physical (surgery vs no surgery) impact of both management options. In addition, it is unclear what the physicians’ preferences are, and what the impact of both ‘treatments’ can have on quality of life and costs.
The aims of our study are:
- to assess the uptake in the LORD trial, and reasons to decline trial-participation;
- to assess the psychosocial and economic impact of active surveillance (yearly mammogram) and breast surgery in women with low-grade DCIS;
- to assess patient preferences and the balance between pros and cons of the mental (worries, risk perception) and physical (surgery vs no surgery) impact of both treatment options;
- to investigate the attitude of clinicians towards active surveillance over time.
The study will be carried out in close collaboration with the PRECISION patient advocates and will provide crucial information on the acceptance of active surveillance in terms of the psychological, physical, organizational and economic benefits and limitations.