Ductal Carcinoma in Situ
Between 30-50% of the new breast cancers that are detected through mammography screenings are classified as Ductal Carcinoma in Situ. DCIS refers to the abnormal growth of cells that are encapsulated within the milk ducts of the breast. It is a calcified lesion that is approximately 1 – 1.5 cm in diameter and is considered to be a non-invasive or “zero stage” cancer with some experts arguing for its complete re-classification as a non-cancerous condition. Most people who are diagnosed with DCIS generally remain asymptomatic and have no palpable lesions.
Diagnosis of DCIS has now reached epidemic proportions due to the widespread use of highly-sensitive mammography screening tools.
It is very telling that women in the United States have the highest rates of mammography screening in the world and we also have the highest rates of DCIS as well. For most of the twentieth century, mastectomy was the first line of treatment for those diagnosed with (DCIS), with younger patients more likely to undergo this surgery. In 2002, 26% of DCIS patients were still receiving this surgical procedure. The most common treatments being recommended by oncologists today are for the patient to undergo a lumpectomy followed by radiation and then given hormone suppression drugs such as Arimidex or Tamoxifen.
Proponents of breast cancer screening claim they are saving lives through the use of early detection and with over-treating those with DCIS, often regarding it as a potentially life-threatening condition. They view DCIS as a “pre-cancerous”condition and argue that, because it could cause harm at some point, then it should be treated in the same aggressive manner as with any other invasive cancer. Those treatments would include surgery, radiation, and hormone therapies. The real tragedy here is that women are not being told the true nature of DCIS, or the concept that there may be such a thing as a “non-progressive” cancer. In a poll on DCIS awareness that was published in 2000, 94% of the women who were studied had doubts that there could be such a thing as a non-progressive breast cancer, in other words, they had no understanding of the true nature of a DCIS diagnosis.
Recent findings, published in June of 2015 in the journal JAMA Oncology, found that DCIS rarely leads to death from breast cancer. The rate at which DCIS may progress into a terminal cancer indicates that it may be as low as 2% with the 10-year survival rates of patients who are diagnosed with DCIS is at 98% post-treatment. The research also reveals that pursuing treatment beyond a lumpectomy did not affect overall survival time. This extraordinary high number speaks volumes as to the benign nature of the condition. These findings also add to the concerns that the ability to detect these lesions through highly sensitive mammograms may be leading to unnecessary mastectomies and treatments. Even more troubling, DCIS survival statistics are being included in our national cancer database as “proof” that these screenings are effective, but a closer look reveals that including DCIS data may only be skewing our nation’s survival statistics in general, and making it seem as if mammography is doing a more effective job at detecting these cancers, and that conventional therapies are working to heal those who are diagnosed. That way we can continue to believe that we are “winning” the war on cancer.
Read more articles from this breast cancer series