Whether you have concerns for yourself or a loved one, a breast cancer diagnosis can be a frightening prospect. However, a recent study offers the hope of less-invasive treatments for slow-growing cancers.
Ductal carcinoma in situ (DCIS) is a grouping of abnormal cells in the lining of the milk duct that appear similar to cancer cells. DCIS is often called stage 0 breast cancer because these cells have not moved beyond the milk ducts. Close to 60,000 women are diagnosed with DCIS each year, with most undergoing a lumpectomy with or without radiation, mastectomy or preventive double mastectomy.
The new study, published in JAMA (Journal of American Medical Association) Oncology by Toronto researchers, looked at data from 100,000 breast cancer patients over 20 years and found that death rates from breast cancer between women who had invasive treatments, such as lumpectomies or mastectomies, were basically identical to those that received no such treatment.
Breast care specialists are carefully reviewing this new research, but are not quick to change their current treatment protocols. The removal of DCIS, either via lumpectomy — removal of part of the breast — or mastectomy — complete removal of the breast, will not likely subside until further research is conducted.
“There is no way to know which cells will progress to invasive disease and which can be left alone,” says Dr. Christina Casteel, medical director of the Breast Health Center at Sharp Memorial Hospital. “I don’t foresee changes to the way we treat DCIS until there’s data supporting modification of the current standard of care, which is surgery. For now, these findings will simply open discussion and fuel more study.”
“We don’t know if all DCIS is the same,” says Dr. Casteel. “There may be a high-risk group and a low-risk group of patients, and we might find that we don’t have to treat both the same.”
It may one day be determined that DCIS need only be monitored to ensure the abnormal cells have not spread.
Luckily, DCIS mortality rates are low even in women who are considered high-risk, such as African-American women and those diagnosed at age 35 or younger. So until doctors know for sure whether surgery is unnecessary for women with DCIS, doctors can use the new findings to counsel patients on their treatment options and potentially relieve concerns.
Dr. Casteel recommends that women of all ages continue to perform monthly breast self-exams, and that women talk with their doctor about when and how often to have a mammogram.