A group of specialists at the National Cancer Institute recently issued a report calling for a redefinition of the word “cancer,” suggesting that it no longer be applied to certain premalignant and non-lethal conditions. Such a change, the panel wrote, may ease the fears of patients, making them less inclined to seek unnecessary and potentially harmful treatments. The findings reinforce earlier studies by physicians at Dana-Farbers’ Susan F. Smith Centers for Women’s Cancers and others.
An example of this kind of condition is ductal carcinoma in situ (DCIS), in which cancerous cells are confined to the milk ducts of the breast. It is the most common form of non-invasive breast cancer, found in more than 60,000 women in the U.S. each year, according to the American Cancer Society.Here, Eric Winer, MD, director of the Breast Oncology Center at the Susan F. Smith Center for Women’s Cancers at Dana-Farber, answers some common questions about DCIS and its treatment.
Q: Should DCIS be considered cancer?
It doesn’t matter what we call it. It matters that women have a conversation with their physician about what DCIS is and what a diagnosis of the condition means. DCIS cells are true cancer cells, but they’re located entirely within the milk ducts of the breast.
Q: Is DCIS a life-threatening condition?
A woman’s chance of dying from DCIS itself is almost zero. The reason DCIS is important is that, if left untreated, it has the potential to become invasive breast cancer.
Q: If I have calcifications in a breast, does that mean I have DCIS?
Most calcifications are not a sign of DCIS. In some cases, however, the appearance of certain calcifications on a mammogram increases the likelihood that DCIS is present.
Q: Do women with DCIS need to be treated?
Because of the risk that DCIS is a forerunner of invasive breast cancer, we recommend treatment.
Q: What are the treatments for DCIS?
Treatment typically includes surgery, sometimes followed by radiation and/or hormonal therapy. The type of surgery performed is usually a lumpectomy, in which only the abnormal tissue and a layer of surrounding tissue are removed. Sometimes a mastectomy is performed, in which the entire breast is removed. Mastectomy may be recommended if the DCIS is very extensive and the surgeon cannot remove it entirely with a lumpectomy.
Radiation therapy is generally given after a lumpectomy, although there is a great deal of debate over who should and shouldn’t receive radiotherapy after a diagnosis of DCIS. Occasionally, the drug tamoxifen is prescribed to prevent a recurrence of DCIS.
You can see a video on DCIS here.