Earlier this summer the Journal of the American Medical Association (JAMA) published a study suggesting that the current standard treatment for DCIS may be too aggressive. DCIS stands for ductal carcinoma in situ, and occurs when microscopic cancer cells are localized in the ductal system of the breast but haven’t invaded surrounding tissue.
Currently, the standard treatment is to remove the affected tissue by means of a lumpectomy or a mastectomy. Sometimes surgery is followed by radiation and often includes follow-up medications. The article stated: “The researchers studied more than 108,000 women who had been diagnosed with DCIS at some point during a 20-year period. They found that women who received a lumpectomy followed by radiation had a lower risk of cancer returning in the affected breast. But the addition of radiation did not change the ultimate rate of death due to breast cancer. Nor did performing a mastectomy instead of a lumpectomy.”
Media coverage went crazy and actually insinuated that DCIS didn’t need any treatment at all, just careful follow-ups. Let’s look at the facts:
- This was an observational study and didn’t allow for follow-up questions or investigations.
- The study did not document which, if any, patients also received hormonal therapy in addition to surgery.
- The media was completely wrong in leaving the impression of “no treatment needed” since every single woman in the study had some type of treatment.
- There are ongoing trials to determine whether a “watchful waiting” approach is reasonable for some women - we need to wait to see the results of those studies.
DCIS can be a precursor in some women to an aggressive cancer so you need to have a serious talk with your doctor about your individual risk and determine what is best for you. That is really the bottom line - women are not a one size fits all group. You need to do what is right for you and feel comfortable with your decision. Then you can move forward with confidence.
The best defense against breast cancer? Yearly screenings. Contact The Woman’s Clinic to schedule your mammogram today.