dcis breast cancer

“The removal of 50,000 to 60,000 DCIS lesions has not been accompanied by a reduction in the incidence of invasive breast cancers”

 

Laura J. Esserman, MD, MBA
Director, Carol Franc Buck Breast Cancer Center

START HERE: With these articles that frame the basic issues and controversy surrounding DCIS breast cancer treatment.

“Doubt Is Raised Over Value of Surgery for Breast Lesion at Earliest Stage” By Gina Kolata, August 20, 2015, New York Times 

“Ductal Carcinoma In Situ, A Case Vignette” New England Journal of Health- This provides a “Point vs. Counter Point” review of DCIS treatment and interesting commentary and a poll of doctors opinions.

The Danger of DCIS, The Breast “Cancer” That’s Often Not –In response to one of the most commonly diagnosed breast “cancers,” Dr. Shelley Hwang is staging a radically conservative campaign to save our breasts. 

Why Doctors Are Rethinking Breast-Cancer Treatment – This Article includes an excellent video by Shelley Hwang, Chief of Breast Surgery, Duke University.

Opinion 

“Rethinking the Standard for Ductal Carcinoma In Situ Treatment”, Journal of the American Medical Association (JAMA), by Laura Esserman, MD, MBA; Christina Yau, Ph.D. –This opinion article asks a number of provocative questions that have accelerated the debate over DCIS treatment. The first page is available free and covers the major points presented. The full text is available at a cost but there is not a lot beyond the first page.

Research Studies For DCIS Breast Cancer

“Breast Cancer Mortality After a Diagnosis of Ductal Carcinoma In Situ” by Steven A. Narod, MD, FRCPC – This study set off a much broader debate with some doctors vehemently defending surgery treatment while others began to question it.

The natural history of ductal carcinoma in situ of the breast: a review– This is the study that suggests 22% of untreated DCIS breast cancer cases become invasive cancers (i.e 78% do not become invasive cancers). It is controversial.

“Active Surveillance for DCIS: The Importance of Selection Criteria and Monitoring “ There are three current trials that are trying to determine if active surveillance is a better approach for some.

After Surgery- Risks and Pain 

“Risk Factors Linked to Pain After Breast Cancer Surgery”

When Pain Persists After Breast Cancer Surgery 

Breast Cancer Survivors Face Years of Post-Surgery Pain 

Other Materials (Articles, research, Resources) -DCIS Breast Cancer

“Do I Need Surgery for DCIS? by Deanna J. Attai, MD, FCAS 

“DCIS Treatment and Survival Rates” by Deanna J. Attai, MD, FCAS

Breast Cancer Treatment and D.C.I.S.: Answers to Questions About New Findings : 

Low-rate of mortality from breast cancer DCIS diagnosis 

Varied Reactions to Study Finding That Preventing Ipsilateral Recurrence Did Not Prevent Death From Breast Cancer” 

144 Page DCIS Booklet- (This Booklet has a lot of information mostly focused on “standard of care” treatments and is available for a fee) We have no financial interest in any fees paid for this booklet.

Other Research Studies 

Outcomes for Women with Minimal-Volume Ductal Carcinoma In Situ Completely Excised at Core Biopsy 

NIH state-of-the-science conference statement: diagnosis and management of ductal carcinoma in situ (DCIS).

Breast cancer-specific mortality after invasive local recurrence in patients with ductal carcinoma-in-situ of the breast.

Breast Cancer Specialists 

These specialists are known to have an open mind regarding active surveillance and the controversy surrounding DCIS breast cancer treatment. Please advise us, in our comment section, of other doctors whom you feel provide a full spectrum of treatment options that include discussion active surveillance

Laura J. Esserman, MD- Breast Cancer Consultation and Surgery

Deanna J. Attai, MD, FCAS- Breast Cancer Consultation and Surgery

Shelley Hwang, Chief of Breast Surgery, Duke University

Wen Liang, Breast Surgeon at Anne Arundel Medical Center, Maryland

Jean F. Simpson, MD, for second opinions on your pathology report

HELPFUL LINKS, BLOGS and PEER SUPPORT

DCIS 411 Bolg- This blog, by Donna Pinto, who has been a patient and patient advocate since 2010 

DCIS Redefined-

DCIS Precision –a site run by doctors and dedicated to eliminating overtreatment of DCIS breast cancer