describe a non-invasive type of breast lesion may affect how women choose to
have the abnormal cells treated, a new survey suggests.
carcinoma in situ, or DCIS, accounts for about one in every five new breast
cancer diagnoses in the United States when it's included in cancer statistics.
DCIS may spread and become invasive cancer, but is not life-threatening on its
own – and some researchers question whether it should be called
"cancer" at all.
women with DCIS undergo breast-conserving surgery or a mastectomy. The new
findings suggest doctors using the phrase "non-invasive cancer" to
describe DCIS, rather than "breast lesion", for example, may be one
reason women tend to go that route.
think it's often the case that patients hear the word 'cancer' and that's all
they really take in, and the non-invasive component is missed," Elissa
Ozanne, who worked on the study at the University of California, San Francisco,
said. "Certain terminologies can confer potentially unintended
messages," she told Reuters Health.
DCIS puts you at higher risk for invasive breast cancer, but it's not at all
the same as having invasive cancer," Heather Gold, a breast cancer
researcher and associate professor at the New York University School of
Medicine, said. "If we're over diagnosing this and calling it cancer, then
we're also in turn over treating," she said.
with DCIS can be treated with medications such as tamoxifen or managed with
so-called active surveillance – regular screening to make sure the cancer
hasn't become invasive – the researchers said.
study, Ozanne and her colleagues surveyed 394 healthy women on what treatment
they would choose if diagnosed with a hypothetical condition. Women were
presented with the same table of possible outcomes and treatment options for a
"non-invasive breast cancer," a "breast lesion" or
"abnormal cells" – all ways to describe DCIS.
the most popular option for a hypothetical "non-invasive breast
cancer." Just under half of women picked surgery in that scenario, while
one-third opted for active surveillance. Those proportions flipped when the
diagnosis was given instead as a "breast lesion" or "abnormal
cells," according to the findings published this week in JAMA Internal
people think that the time frame over which DCIS might progress (to invasive
cancer) can be anywhere from five to 40 years for the low-grade cancer,"
Ozanne said. "In some cases it may be many, many years before something
progresses, and many cases are thought not to progress. "Gold, who was not
involved in the new study, called it "very timely".
of women with DCIS assume they have cancer. Women who think it's cancer are
more likely to be more aggressive with their treatment," when they might
have been able to avoid surgery completely, she told Reuters Health.
have this problem of over diagnosis, and that is followed by over treatment. "The researchers noted their survey was based on
hypothetical diagnoses, and did not include women with DCIS, who might have
answered the survey questions differently. Gold said women who are diagnosed
with DCIS should discuss the possible risks with their doctor and make sure
they fully understand the intricacies of their diagnosis. Some types of DCIS
are very aggressive and can grow quickly, she said, while others typically do