© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 23, 1811-1817,
December 5, 2001
© 2001 Oxford University Press
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Breast Carcinoma In Situ: Risk Factors and Screening Patterns
Affiliations of authors: E. B. Claus (Departments of Epidemiology and Public Health and Neurosurgery), M. Stowe (Department of Epidemiology and Public Health), D. Carter (Department of Pathology), Yale University School of Medicine, New Haven, CT.
Correspondence to: Elizabeth B. Claus, Ph.D., M.D., Department of Epidemiology and Public Health, Yale University, 60 College St., P.O. Box 208034, New Haven, CT 06520-8034 (e-mail: claus{at}biomed.med.yale.edu).
Background: Risk factors associated with invasive breast cancer are well documented, but those associated with breast carcinoma in situ are not well defined. Methods: We conducted a population-based, case–control study among female residents of Connecticut to identify risk factors for breast carcinoma in situ. Case patients, diagnosed with ductal carcinoma in situ (DCIS) (n = 875) or lobular carcinoma in situ (LCIS) (n = 123), were matched by 5-year age groups with control subjects (n = 999). Case patients were diagnosed between September 15, 1994, through March 14, 1998, and all subjects were between the ages of 20 and 79 years. Information on risk factors and cancer-screening history was collected by telephone interviews. Conditional logistic regression was used to determine odds ratios (ORs) for the association of these factors with the risk of DCIS and LCIS. Results: Case patients with DCIS were more likely than control subjects to report a family history of breast cancer (OR = 1.48; 95% confidence interval [CI] = 1.19 to 1.85) or previous breast biopsy (OR = 3.56; 95% CI = 2.86 to 4.43). They also had fewer full-term pregnancies (OR = 0.86; 95% CI = 0.80 to 0.93) and were older at first full-term pregnancy (OR for being 20–29 years old relative to being <20 years old = 1.68; 95% CI = 1.17 to 2.43) and at menopause (OR for being 
55 years old relative to being <45 years old = 1.71; 95% CI = 1.05 to 2.77). DCIS case patients were more likely than control subjects to have had a mammographic examination (OR = 2.46; 95% CI = 1.78 to 3.40) or an annual clinical breast examination (OR = 1.83; 95% CI = 1.48 to 2.26). DCIS patients and control subjects did not differ with respect to oral contraceptive use, hormone replacement therapy, alcohol consumption or smoking history, or breast self-examination. Associations for LCIS were similar. Conclusions: The risk factors associated with DCIS and LCIS are similar to those associated with invasive breast cancer. Diagnosis of DCIS is associated with increased mammography screening.
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