What is DCIS? Is it “cancer?” The changing of terminology has recently been discussed on the news- and by referring to DCIS as non cancerous, more and more women are opting for more non-surgical options. The words doctors use to tell a woman she has ductal carcinoma in situ can make a big difference in the treatment she chooses. Ductal carcinoma in situ, or DCIS, can be an early form of breast cancer. But in many cases, the tumor never grows beyond the milk duct where it was found.
Here is DCIS as explained on breastcancer.org website:
Ductal carcinoma in situ (DCIS) is the most common type of non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and in situ means “in its original place.” DCIS is called “non-invasive” because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on.
When you have had DCIS, you are at higher risk for the cancer coming back or for developing a new breast cancer than a person who has never had breast cancer before. Most recurrences happen within the 5 to 10 years after initial diagnosis. The chances of a recurrence are under 30%.
Women who have breast-conserving surgery (lumpectomy) for DCIS without radiation therapy have about a 25% to 30% chance of having a recurrence at some point in the future. Including radiation therapy in the treatment plan after surgery drops the risk of recurrence to about 15%. According to the American Cancer Society, about 60,000 cases of DCIS are diagnosed in the United States each year, accounting for about 1 out of every 5 new breast cancer cases.
Most people with DCIS have a lumpectomy followed by radiation therapy. This is usually a very good option if the DCIS only appears in one area of the breast and can be completely removed with clear margins of healthy tissue. A clear margin is a rim of healthy tissue around the tumor that is completely free of cancer cells. How wide do these margins need to be? Doctors are still debating the answer, but a width of 2 to 3 mm is common.
Lumpectomy, and in some cases a second procedure called re-excision lumpectomy, is used to completely remove the cancer.
• Lumpectomy removes the entire area of DCIS as well as a margin of normal, healthy breast tissue around it. The whole area that contained cancer cells is removed, even when there’s no lump present.
• Re-excision lumpectomy is a second surgery that may be necessary after lumpectomy to remove extra tissue in order to ensure that there is a clear margin of healthy tissue around the tumor. If your doctor finds that the margins of healthy tissue taken were too narrow, or there is even some cancer present in the margins, a re-excision may be recommended.
If the DCIS has been removed with lumpectomy, radiation is usually given to reduce the risk of cancer returning.
What do you think? Should DCIS be called “Cancer” or not? Would women opt for a different treatment if the word “Cancer” was left out of the diagnosis?
For more information on DCIS visit www.breastcancer.org and read a great article in the LA Times dated 8/26/13 written by Karen Kaplan: Women told they have breast ‘cancer’ more likely to want surgery.
