Breast cancer scares, lumpectomy’s and medical treatment is overdone says a new study featured in the NY Times.
When cancer is mentioned, or even pre-cancer, people have been trained to be fearful and want something done to help them avoid dying from the disease process. Women in our society have been so preconditioned to want to take action, with any breast cancer concerns, especially if other family members were affected by the disease in the past.
Ductal carcinoma in situ, or D.C.I.S., has become increasingly controversial over the years, since it is found in mammograms, rather than manual inspection. According to a NY Times article “As many as 60,000 women are told each year that they have it: tiny clusters of abnormal breast cells, confined to a milk duct and too small to be felt. It’s often called stage 0 cancer, and it almost never was detected before the early 1980s when mammograms came into widespread use.”(1)
The problem is that this diagnosis has resulted in hundreds of thousands of lumpectomies and mastectomies due to fear resulting in medical overtreatment.
Women who have had mastectomies and lumpectomies may have also had both physical and psychological scars from a condition that may just have needed to be watched over time to see if any progression took place. Based on the new studies, future recommendations is likely to include watching and waiting, rather than any treatment. D.C.I.S. may in fact just be a normal variant found in women that the medical community did not understand very well. The result was of course many unnecessary procedures to cure a “what if” disease that was previously thought to be life-threatening.
The JAMA (Journal of the American Medical Association studied 20 years of data from 100,000 women who had the condition and found that there was no greater risk of women dying from D.C.I.S. and developing breast cancer than the general population. In other words, sometimes the best thing to do is nothing, and just monitor the patient to see if there is any change over the years. This is a better approach since some tumors have become dangerous only after a surgery was performed, mitigating any therapeutic effect the surgery may have had.
A few years ago, a study had shown that mammograms may in fact be more harmful than good if done too often, leads to medical overtreatment (read more here). As a result, insurance carriers are now only paying for the procedure every other year. For every person saved by a mammogram, there may be 45 or so that had unnecessary and potentially harmful procedures based on fear and a lack of understanding of what the mammogram’s limitations are as a reliable diagnostic tool.
The medical community is now trying to understand D.C.I.S. better, and understand what it is; cancer; pre-cancer, a risk factor, a normal variant or something else.
You can read more about D.C.I.S. here. For now, if you were diagnosed with this condition and are recommended aggressive treatment, you may consider getting a second opinion.
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