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Is this type of breast cancer even cancer?

January 13, 2010 |  1:00 pm

BreastcancerDoctors have long debated what to do about a type of breast cancer called DCIS, or ductal carcinoma in situ, not because it's particularly dangerous -- because it isn't.

Today, in a report published online in the Journal of the National Cancer Institute, experts on the disease summarize what is known about DCIS and call for more research on how to ease off treatment for many of the people diagnosed with DCIS. A commentary accompanying the paper even calls for dropping the term "cancer" to describe it.

The issue is important because 25% of all breast cancers diagnosed in the United States are DCIS. DCIS is defined as an abnormal collection of cells in the milk ducts of the breast. It can be life-threatening in some cases. But most of the time DCIS is a low-grade tumor that is best described as something between normal breast tissue and breast cancer. In this country, women diagnosed with DCIS have surgery to remove the tumor, and survival rates are 98%.

But researchers have long wondered whether DCIS should even be treated. "The relationship between DCIS and invasive breast cancer remains unclear," said the authors of the report, led by Beth A. Virnig of the University of Minnesota. "It is entirely clear that much DCIS either would not develop into invasive disease or would do so much later in life, perhaps never becoming clinically relevant."

Questions remain on whether certain biomarkers, such as presence of the HER2 gene mutation, could be used to clarify who should be treated. Clearly, more research is needed to try to figure out whose DCIS is potential dangerous and whose is likely harmless. For now, the authors state, it's best to continue to treat DCIS as a tumor related to invasive breast cancer. However, in a commentary, Dr. Carmen J. Allegra, of the University of Florida, says it's time to consider a name change to reflect the biological nature of DCIS. That might ease the minds of people diagnosed with DCIS.

"...strong consideration should be given to remove the anxiety-producing term "carcinoma" from the description of DCIS," she wrote.

-- Shari Roan

Photo credit: K.Beebe / Custom Medical Stock Photo

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Comments (4)

Unfortunately this article carries the same emphasis on "anxiety" as the mammogram-or-not debate of recent days. How about knocking off the "easing minds" bit, as if women are little hothouse flowers who can't take stress, and address women's legitmate concerns about inefficiency and inaccuracy of breast cancer screening, diagnosis, and treatment? I don't see anyone calling for prostate cancer being re-termed Slow Growing Weird Prostate Cell Condition so men won't be anxious.

Excellent! This is the sort of research that needs to be done, to help put an end to the hysteria over when women should get their first mammogram and with what frequency thereafter.

Simply finding lumps isn't enough, it's what those lumps mean that's critical.

How about lobular carcinoma insitu, it it more serious that ductal?

I'm a 2-time bc survivor and thriver - and have been totally revived by a dvd i just found made for women with breast cancer called 'The Path of Wellness And Healing.' It's like an encyclopedia for breast cancer but it's also moving, inspiring, the whole nine. Every doctor from deepak Chopra to Dean Ornish is on it and every celeb bc survivor from Sheryl Crow to Melissa Ethridge. So awesome!!!



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