General Medical · Health

Breast Health: Breast Cancer Prevention and Early Detection Both Save Lives

There is another reason why a woman considering a “no treatment” approach to DCIS needs to proceed with caution. When an abnormality is identified on a mammogram and a needle biopsy is done and shows “DCIS,” we ultimately remove this area in its entirety (with lumpectomy or mastectomy). When we examine the tissue that was removed at surgery, approximately 10 percent of the time there will actually be invasive cancer in and around the area of the original biopsy. In other words, the needle biopsy under-estimated and under-sampled the true extent of disease. So if 100 women went untreated for what was “DCIS” on the biopsy, approximately 10 of them might actually be undergoing no treatment for what is actually invasive cancer.

RELATED: Sex and Breast Cancer

In this country, one of the most common cancer-related lawsuits is failure to diagnose or treat breast cancer. The hypocrisy here is undeniable: we can’t advocate for not treating what may be potentially life-threatening cancer on one hand, yet permit lawsuits for failing to diagnose and treat it on the other. So when discussing the “watching and waiting” approach for DCIS, one very real question that first needs to be answered is, “How do we know for certain that it’s just DCIS?” And the answer is: we don’t.

For the millions of women who have been treated for DCIS and the approximately 60,000 that will be diagnosed this year and the years to come, DCIS is the most curable form of breast cancer with cure rates of approximately 97 percent, and with the right care, a woman with DCIS has every reason to be optimistic and expect an excellent long-term outcome. Through research, progress has been and will continue to be made, and more and more options will become available. Perhaps one day soon, with research leading the way, we will be able to confidently advise a large proportion of women with DCIS that “no treatment” is a safe and viable option. Believe me, even those of us who make our living by performing breast surgery would welcome that day. But that day is not today.

For now, we who are on the front lines of cancer treatment taking care of women (and men) with breast cancer every day look at each case in detail and work with each person to decide jointly what is best for each particular case. In general, the data shows that the treatment choices that we and our patients make together are sound and should not be a continued source of anxiety, confusion, and second guessing. Let’s at least make that part clear because our patients deserve that.

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  • Ricel February 2, 2016 at 5:33 pm

    Hi Dr. Elisa Rush Port,

    Thank you so much for this post. I never thought that being obese is also one of the risk factors for breast cancer. Everyone especially women must keep being physically fit and healthy to avoid this risk.

    This article is such a wakeup call for everyone. I find it very insightful. Thanks for sharing!

    Reply