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Study questions early stage breast cancer treatment

August 20, 2015 | Patricia Harriman
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UCI Health surgical oncologist Dr. Karen Lane does not believe the results of a study released today are a reason to change the current approach to treatment for ductal carcinoma in situ. Most of the 60,000 American women diagnosed with ductal carcinoma in situ (DCIS) each year undergo a mastectomy or lumpectomy.

No improvement in survival rates

According to study published in JAMA Oncology, these treatments do not improve survival rates, raising the possibility of over-treatment. DCIS is considered a stage 0 cancer, and accounts for 20 percent to 25 percent of breast cancers that mammogram screenings detect.

“There may be reason to suspect that over-treatment of DCIS is possible, but we do not have any data that gives us confidence to completely eliminate treatment,” Lane said. 

“The data on this subject is still very immature, and at this time, we do not have any proven method to identify those women whose risk of developing cancer is low enough to eliminate standard treatment.”

Dr. Otis S. Brawley, chief medical officer of the American Cancer Society, and Dr. Monica Morrow, chief breast surgeon at Memorial Sloan Kettering Cancer Center, share Lane's views.

More study needed

In a New York Times article about the study, Brawley said that while treatment may have been “excessive,” he is not ready to eliminate it until a large clinical trial can be conducted that shows most patients don’t need it. 

Morrow said that it “makes more sense to view DCIS as a cancer precursor that should be treated the way it is now with a lumpectomy or mastectomy.”

The study, entitled “Breast Cancer Mortality After a Diagnosis of Ductal Carcinoma In Situ,” is based on data collected from 100,000 women followed for more than 20 years, the most extensive data collection on the condition. 

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