Early-Stage Breast Condition May Not Require Cancer Treatment
Source: New York Times
As many as 60,000 American women each year are told they have a very early stage of breast cancer Stage 0, as it is commonly known a possible precursor to what could be a deadly tumor. And almost every one of the women has either a lumpectomy or a mastectomy, and often a double mastectomy, removing a healthy breast as well.
Yet it now appears that treatment may make no difference in their outcomes. Patients with this condition had close to the same likelihood of dying of breast cancer as women in the general population, and the few who died did so despite treatment, not for lack of it, researchers reported Thursday in JAMA Oncology.
Their conclusions were based on the most extensive collection of data ever analyzed on the condition, known as ductal carcinoma in situ, or D.C.I.S.: 100,000 women followed for 20 years. The findings are likely to fan debate about whether tens of thousands of patients are undergoing unnecessary and sometimes disfiguring treatments for premalignant conditions that are unlikely to develop into life-threatening cancers.
Diagnoses of D.C.I.S., involving abnormal cells confined to the milk ducts of the breast, have soared in recent decades. They now account for as much as a quarter of cancer diagnoses made with mammography, as radiologists find smaller and smaller lesions. But the new data on outcomes raises provocative questions: Is D.C.I.S. cancer, a precursor to the disease or just a risk factor for some women? Is there any reason for most patients with the diagnosis to receive brutal therapies? If treatment does not make a difference, should women even be told they have the condition?
Read more: http://www.nytimes.com/2015/08/21/health/breast-cancer-ductal-carcinoma-in-situ-study.html?ribbon-ad-idx=3&rref=health&module=Ribbon&version=context®ion=Header&action=click&contentCollection=Health&pgtype=article
RobinA
(9,894 posts)is incredibly misleading. What I get from this is that if you have DCIS, all the available treatments are equally effective at reducing your chances of dying of breast cancer to that of the general population. There is NO comparison with people with DCIS who went untreated, which there would have to be in order to state "may not require treatment."
LuckyLib
(6,819 posts)after getting the diagnosis would consent to be in the "don't treat" group?
still_one
(92,372 posts)First of all this is a Retrospective study, and retrospective studies have major deficiencies built into them
"Observational study of women who received a diagnosis of DCIS from 1988 to 2011 in the Surveillance, Epidemiology, and End Results (SEER) 18 registries database. Age at diagnosis, race/ethnicity, pathologic features, date of second primary breast cancer, cause of death, and survival were abstracted for 108 196 women. Their risk of dying of breast cancer was compared with that of women in the general population. Cox proportional hazards analysis was performed to estimate the hazard ratio (HR) for death from DCIS by age at diagnosis, clinical features, ethnicity, and treatment."
Also, the methods used to treat early stage breast cancer in 1988, are not the same used today, which also could skew the results.
The idea behind early detection is to catch it before it spreads to the lymphs and beyond. Both surgical, radiation, and Estrogen and Progesterone sensitive, along with Fluorescence in situ hybridization (FISH), and other genetic tests also dictate the treatment options, which are certainly more advanced today than they were in 1988.
In fact their are double blind studies, that depending on the tumor classification and type, the risk of recurrence can be reduced as low as 3%, and even in those cases that are not ERA/PRA sensitive or other factors, the risk of recurrence is still reduced significantly, I think to about 15%
Daemonaquila
(1,712 posts)It requires treatment. This is more propaganda for the "please don't make us pay for anything, especially if it's a women's problem" insurance lobby.