July 4, 2005 at 7:14 PM CDT - Updated June 29 at 9:30 PM
DCIS: What do I do?
Each year, more 55,000 women are diagnosed with ductal carcinoma in situ -- a pre-cancerous cluster of spots in the milk ducts of the breast. For many, this diagnosis can be confusing.
Phyllis Leocha was diagnosed witht he condition a few months ago. Doctors found a pre-cancerous spot on her breast -- a diagnosis known as DCIS.
“It was confusing because the doctor said a couple of different things. He said cancer, and then he said precancerous,” Leocha says.
DCIS is seen as a cluster of tiny white spots. Those clusters can spread to other parts of the breast. But in about one-third of cases, DCIS will stay in the ducts and will never turn into cancer. “But we don’t have crystal balls that tells us who’s in which category,” says breast surgeon Beth-Ann Lesnikoski, M.D., from Dana-Farber Cancer Institute in Boston.
Dr. Lesnikoski says that leaves many women uncertain about their treatment options. “It is pretty confusing. I think it can take a long time to educate a woman as to what her choices are.”
Some of those choices include a mastectomy, a lumpectomy with radiation, and in rare cases, nothing at all. With a mastectomy, there’s a 99-percent chance that any potential cancer will not return. With a lumpectomy and radiation, it’s about 70 percent. But there’s no guarantee if patients decide to forgo treatment.
At first, Leocha wanted to play it completely safe with a mastectomy, but she ultimately opted for a lumpectomy with radiation, which worked. She says: “You eat a bite at a time. You take one step at a time, and I'm glad I took that route.”
A lumpectomy without radiation is another option for patients with DCIS. Chemotherapy is not a treatment option for these patients and is only used for those with invasive breast cancer. Dr. Lesnikoski always recommends treatment for patients with DCIS and emphasizes it’s extremely rare for patients to choose no treatment at all.
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