Breast cancer doesn’t just happen in October
A recent study published by JAMA in September 2015 investigating a large number of women treated for Ductal Carcinoma in situ (DCIS) demonstrates that mastectomy treatment is not necessary. A majority of the 100,000 patients in the DCIS database the researchers used, from a national cancer registry, had lumpectomies, and nearly all the rest had mastectomies. Their chance of dying of breast cancer in the two decades after treatment was 3.3 percent, no matter which procedure they had, about the same as an average woman’s chance of dying of breast cancer. The data showed that some patients were at higher risk: those younger than 40, black women and those whose abnormal cells had molecular markers found in advanced cancers with poorer prognoses. We have also seen in our practice that women with biopsy-proven DCIS seen on MRI as involving an extensive area, that invasive cancer may actually be diagnosed from the cancer specimen once the “DCIS” is removed. Women diagnosed with DCIS and breast cancer present with a broad spectrum of involvement and severity, so it is impossible to have universal, broadly applicable rules on appropriate therapy. Women need to be advised by a medical or surgical specialist who is focused on breast cancer treatment to best understand the most optimal care specific to them.