Earlier this month, we published an article entitled DCIS – Or, Ductal Carcinoma In Situ Part One where we talked about what DCIS is. ThermApproach is committed to educating you on your breast health. As a result, here is DCIS – part two.
As we stated, DCIS, according to many experts, shouldn’t even be considered a form of breast cancer to begin with. With that in mind, let’s look a little further at what causes a dilemma within the medical community when it comes to treatment, and what that means for you.
Breast cancer is staged according to a system that gauges how large the tumor is, and how far it has spread. DCIS is stage 0. What that means is that it hasn’t spread outside the breast duct (where virtually ALL breast cancer begins) into the surrounding tissue. For this reason, DCIS is often referred to as pre-cancer.
It’s important to note, that, if left untreated, some DCIS lesions do go on to become invasive cancers, while others remain harmless precancer and never leave the duct. Unfortunately, despite decades of effort, doctors can’t yet tell you which type it is – i.e., will it spread, or will it not? Sadly, that results in breast specialists recommending that all DCIS be treated with surgery; often followed by radiation or hormone therapy. Yet, many are likely to have not needed treatment at all.
In August of 2015, the cancer journal JAMA Oncology published two important papers about DCIS that tested the understanding of DCIS in the medical community and its role in invasive breast cancer. The first, “Breast Cancer Mortality After a Diagnosis of Ductal Carcinoma In Situ,” found that half the time invasive breast cancer develops, it has not developed from a prior DCIS. This finding challenges the orthodox view that DCIS is the original tissue from which most invasive ductal carcinomas (the most common form of breast cancer) develop.
This probably means DCIS is a marker – a woman may have cells somewhere in the breast that either are or will become invasive cancer, but these cells are currently undetectable. In other words, DCIS is functioning more as a risk factor rather than a direct cause in at least half of all breast cancer deaths.
This study is important because it reported on over 100,000 women with DCIS – and because it was based on well-established survey data from 18 different U.S. cancer registries. As a matter of fact, its findings are in line with those from a much smaller study done in Sweden in 2010. The fact that two different studies have reported the same general conclusions make these findings more believable.
It’s important to keep in mind that breast cancer doctors know that women with DCIS have a low risk of dying of breast cancer, but they don’t necessarily believe these findings mean women with DCIS should immediately start receiving less treatment.
This could leave you and your physician in a bit of a quandary. The reason people are given cancer treatments is to reduce the risk of dying. But, you don’t die from DCIS, because the cells can’t wreak havoc when they are inside the duct. As a matter of fact, according to Eileen Rakovitch, a radiation oncologist at Sunnybrook Health Sciences Centre’s Odette Cancer Centre in Toronto, “We know we are overtreating DCIS. In most women, it will not become an invasive breast cancer and it will not be life-threatening. But for some, DCIS is the first step to invasive cancer—and we don’t know who these women are.”
Chances are, you received this diagnosis after having a mammogram done. The incidences of DCIS has increased dramatically with the onset of mammograms.
If you’ve recently been diagnosed with DCIS and haven’t yet made treatment decisions, talk to your healthcare providers about what they think of this study and why or why not, and how, they think it should affect your treatment plan.
We would also encourage you to contact our office and schedule your appointment for a thermal image of your breasts to give you a fuller picture of what is going on in and around your breast tissue.
At ThermAppoach, we utilize sophisticated infrared technology and innovative computer software to capture the images in the form of an infrared thermogram, or heat picture. All reports are interpreted by medical doctors that are Board Certified in Thermology.
Before you can feel it, thermal imaging can see it. Please call our office to schedule your screening today.
 Narod, Steven A. “Breast Cancer Mortality After Ductal Carcinoma In Situ.” JAMA Internal Medicine, American Medical Association, 1 Oct. 2015, jamanetwork.com/journals/jamaoncology/fullarticle/2427491.