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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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