Women with D.C.I.S. must weigh breast cancer surgeries against doing nothing at all

Karen Jaggar

Women who get a lumpectomy or a mastectomy after developing ductal carcinoma in situ, or D.C.I.S., an early form of breast cancer, don’t necessarily increase their chances of living.

That’s the conclusion of a new, extensive study of 100,000 women followed for 20 years, according to a story in The New York Times by the newspaper’s cancer expert, Gina Kolata.

Patients with this condition, also called Stage O, apparently had a 3.3 percent of dying within 20 years of the treatment, regardless of the procedure they underwent — similar to an average woman’s chance of dying of breast cancer.

JAMA Oncology cited the researchers’ findings yesterday, Aug. 20, basing them on what the Times labeled “the most extensive collection of data ever analyzed on this condition.”

D.C.I.S. involves abnormal cells confined to the breast’s milk ducts. Upwards of 60,000 women a year are diagnosed with it.

It is generally agreed in the cancer care community that unnecessary and disfiguring treatments following D.C.I.S. diagnosis have often been excessive, but only a minority of physicians believe the best way to treat the condition is to do nothing.

Kolata’s story quoted one leading doctor as believing D.C.I.S. “should be treated as a precursor to potentially deadly invasive cancers, analogous to colon polyps that can turn into colon cancer.” 

Karen Jaggar, executive director of an educational organization based in San Francisco, Breast Cancer Action, was quoted in the piece as saying women tend not to appreciate the harms of over-treatment and often over-estimate their risk of dying of cancer, “making them react with terror.”

As always, though, this study may quickly be contradicted by new studies already underway. “Rollercoaster: How a man can survive his partner’s breast cancer,” the VitalityPress book I, Woody Weingarten, wrote mainly for male caregivers, details how researchers and physicians can flip-flop “on a dime” about almost any medical decision.