Study questions value of post-Stage O procedures

Women with D.C.I.S. must weigh breast cancer surgeries against doing nothing at all

Karen Jaggar

Women who get a lumpectomy or a mastectomy after developing ductal carcinoma in situ, or D.C.I.S., an early form of breast cancer, don't necessarily increase their chances of living.

That's the conclusion of a new, extensive study of 100,000 women followed for 20 years, according to a story in The New York Times by the newspaper's cancer expert, Gina Kolata.

Patients with this condition, also called Stage O, apparently had a 3.3 percent of dying within 20 years of the treatment, regardless of the procedure they underwent — similar to an average woman's chance of dying of breast cancer.

JAMA Oncology cited the researchers' findings yesterday, Aug. 20, basing them on what the Times labeled "the most extensive collection of data ever analyzed on this condition."

D.C.I.S. involves abnormal cells confined to the breast's milk ducts. Upwards of 60,000 women a year are diagnosed with it.

It is generally agreed in the cancer care community that unnecessary and disfiguring treatments following D.C.I.S. diagnosis have often been excessive, but only a minority of physicians believe the best way to treat the condition is to do nothing.

Kolata's story quoted one leading doctor as believing D.C.I.S. "should be treated as a precursor to potentially deadly invasive cancers, analogous to colon polyps that can turn into colon cancer." 

Karen Jaggar, executive director of an educational organization based in San Francisco, Breast Cancer Action, was quoted in the piece as saying women tend not to appreciate the harms of over-treatment and often over-estimate their risk of dying of cancer, "making them react with terror."

As always, though, this study may quickly be contradicted by new studies already underway. "Rollercoaster: How a man can survive his partner's breast cancer," the VitalityPress book I, Woody Weingarten, wrote mainly for male caregivers, details how researchers and physicians can flip-flop "on a dime" about almost any medical decision.

'Liquid biopsy' — new weapon in cancer battle?

'Rollercoaster' author cheered by blood test that can help locate patients' cancer DNA 

Gina Kolata

"Liquid biopsy," a new blood test, has shown promise of locating cancer DNA in a patient's bloodstream, according to an article in "The New York Times."

The piece appeared April 19 under the byline of Gina Kolata, the newspaper's health writer. 

It encouraged me, Woody Weingarten, and gave me renewed hope.

I tend to be a rose-colored glasses kind of guy anyway, and believe it's cause for celebration any time anything that even resembles a breakthrough pops up.

My book, "Rollercoaster: How a man can survive his partner's breast cancer," will attest to my positive thinking, to my steadfast belief that there can be light at the end of the proverbial tunnel.

Kolata's article says the "hope is that a simple blood draw — far less onerous for patients than a traditional biopsy or CT scan — will enable oncologists to quickly figure out whether a treatment is working."

Failing treatments, she continued, "could be abandoned quickly, sparing patients grueling side effects and allowing doctors to try alternatives."