Word: dcis
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...question about what to do with DCIS is also rife with extenuating factors. If DCIS never left the breast ducts, physicians could safely ignore it. No one knows for sure, but at least one study suggests that perhaps 40% of DCIS lesions will develop into invasive tumors that, if left untreated, could eventually prove fatal. That means that maybe 60% of DCIS cases never threaten a woman's health--and therefore these growths do not need to be removed...
Before the routine use of mammograms, most cases of DCIS were discovered accidentally, often during other surgeries. Thanks to better screening, the absolute number of DCIS cases has jumped seven-fold in the U.S. over the past three decades. "At the moment, we don't know which women diagnosed with DCIS might be able to get by with minimal treatment," says Dr. Eric Winer, director of breast oncology at the Dana-Farber Cancer Institute in Boston. As a result, most doctors agree that it's prudent to treat all DCIS cases as if they are dangerous. (In the past couple...
That's not the only dilemma with DCIS. Radiologists don't actually see a DCIS lesion--they see its footprint in the calcified remains of dead and dying cells. What makes mammography as much an art as a science is that these so-called microcalcifications are often just a normal part of breast anatomy. It's the pattern of microcalcifications--whether new ones appear suddenly or line up in particular formations like soldiers in a row--that suggests something more sinister...
...variety of reasons, radiologists in the U.S. tend to err on the side of caution. That is, they identify lots of "abnormalities," of which only 2% to 11% prove to be cancerous--either DCIS or an invasive tumor. Sometimes a second mammogram or an ultrasound provides the necessary reassurance. Other times, a biopsy--which entails the removal of some breast tissue--is required to resolve any ambiguity. Here the odds of finding cancer rise to about 25%, which means that 75% of biopsies come back negative...
...STAGE 0 DCIS with Microcalcifications...