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Taking Charge of Your Health

21 thoughts on “Ductal Carcinoma In Situ-Is Treatment Necessary?

  1. Thanks for your video.–This is the same as watchful waiting for early prostate cancer. Cancer is cancer—treat early and live longer, healthier. You don't "need" breasts and prostate glands to live…although it's much nicer to have them (if healthy!) though.

  2. @lawmed1 What do I think? Of course I agree! Why stick your head in the sand and pay Russian Roulette when it comes to statistics? You COULD be one of those 3%-5%. It's like the lottery or entering contests; SOMEONE has to "win"….Well, I had MY surgery (open excision after steriotactic biopsy) 3 weeks ago today. Two ducts were removed that had ductal ectasia and papillomas, also 2 areas that had suspicious microcalcs. Ended up hemorrhaging, but I'm Cancer FREE=Peace of mind. 🙂

  3. My sister had DCIS had her breast removed and had only a 1% chance of it coming back and if so it would be in her other breast. She elected no chemo. Right after the 5 year period, it metastasis to the liver stage 4. So I say, go on and take the chemo.

  4. There is the danger of chemo or surgical removal creating more problems then the small risk from the breast cancer. It is important to not only ask about the various treatments, but also to talk about the risks and long term care whether treatment is elected or not at the time of diagnosis. Often times, treatment for treatment sake is more harmful. This harm can be minor irritation and expenses or it can be life threatening. Do not leave the office until all care life cycles has been explain.

  5. I was diagnosed with Stage 0 DCIS in January. I had a lumpectomy and 6 weeks of radiation. Good luck to you! Tell them you want it out !!!!

  6. It would be unusual for any doctor to recommend the "watch and wait" approach for DCIS…unless there is concern that the person won't tolerate the procedure (e.g. due to other health issues, etc ), And even then, they might still recommended anti-estrogen therapy. LCIS, however, is less straightforward. Also, the reluctance to aggressively treat DCIS is related to treatment complications as well as the cosmetic implications. Neither are trivial. It has nothing to do with costs!

  7. Articles about cost-effectiveness exist for every kind of procedure, but you can't reduce a patient to a statistic. Anyone who has treated someone with cancer (in situ or invasive) will tell you that cost rarely factors into the decision to treat (with a few exceptions, I suppose), especially when the guidelines are clear. The current recommendation clearly states that DCIS should be treated in some manner, so to not treat would be unusual (unless the patient refuses treatment).

  8. I was diagnosed with just ductal atypica which the insurance company considers precancer. Given my family history I do not qualify for BRCA 1 or 2 testing and am not at high risk." Do I wait and watch for 15 years? The breast clinic monitoring me told my insurance company that I asked for a total mastectomy (which I did.) I doubt if I will qualify but I think for those women who choose proactively to lessen their risk to less than 5% of getting cancer in situ, we should be allowed the choice.

  9. You're sorry to learn of her troubles and wishing her good luck? You're not offering your services in case she wants to fight for a mastectomy?

  10. My heartfelt sympathies go out to you and your sister. I encourage all women to take the aggressive option when given the choice. I am trying to qualify for total mastectomy for tubal atypia (precancerous) I do not believe in waiting around to see what cancer decides to do and I believe breast cancer patients should be given the choice.

  11. Get the oncotype DX test, to determine the likelihood of recurrence..and make an informed decision based on that.
    Also question aggressively..why why why diagnostic mammography is used all to often instead of ultrasound for eg. wire guided lumpectomy…radiation can in certain individuals create growth in cancer cells…and should not be glibly done just to get another image..limit your screening mammograms to once every two years. Aand if you are in a treatment program for DCIS or cancer, question the frequency of diagnostic use.

  12. Per criteria of one of the two major precert approval guideline systems, DCIS diagnosis is adequate for meeting criteria for partial mastectomy.

  13. I've had a wire-guided lumpectomy with inadequate clear margins. Second lumpectomy in two weeks, then depending on THAT result radiotherapy OR mastectomy. I live in south-west France and my doc said the surgery is preventative. I have the option of mastectomy to avoid radiotherapy, but I personally prefer breast conservation and close monitoring to heavy surgery.

    But I have the good fortune to have breast renconstruction in the same surgery if I do have to opt for mastectomy, and breast realignment (reduction of the other breast to match) in 12 months, all covered by the state (DCIS treatment is 100% financed by the state here in France, just like all cancers and life-threatening disease treatments, and a woman's self-image and quality of life is considered very important here.)

    Americans who live here cannot believe the quality of the treatment.

  14. Treatment for DCIS is based on several factors. Hormone receptors, genetics, age, what grade it's given, etc. There isn't a simple yes or no on whether or not to treat.
    If you've been diagnosed, get a second opinion. Even if you don't feel you need one. Ask each doctor the same list of a million questions and compare their answers. Ask for your pathology report if you have a biopsy and have your doctor explain all the scary science words to you. Talk to people who have had breast cancer but bear in mind no two cases are identical.
    Best of luck!!

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