Since the 1970s, the number of women diagnosed with ductal carcinoma in situ has soared. Ductal carcinoma in situ are abnormal cells that sometimes become breast cancer.
The majority of women diagnosed with DCIS undergo surgery, although there is considerable debate whether surgery is necessary since DCIS sometimes never becomes invasive cancer.
Since 1999 there has been a shift from single mastectomy and toward lumpectomy with radiation. The survival rate from women who had mastectomies was 86% followed by lumpectomy at 80.6%.
Most women in the study group who died didn’t die of breast cancer. For the most part cardiovascular disease was the major killer with just 9% of deaths overall due to breast cancer.
The 10-year survival rates were pretty much identical. 98.9% 10-year survival rates for lumpectomy plus radiation, 98.5% for mastectomy and 98.4% for lumpectomy alone.
From 1991 to 2010, the number of women who chose lumpectomy with radiation doubled, rising from 24% to 47%. While the number of women choosing single mastectomy dropped from 45% to 19%.
The number of women who elected not to have treated rose from 1% to 3%.
However, more women also decided to have bilateral mastectomy raising from 0% to 8.5%. A bilateral mastectomy usually involved removing a healthy breast as well as a breast with DCIS.
Researchers were expecting to see differences in survival based on treatment however there really didn’t seem to be any difference at all. This discovery argues for doing the bare minimum rather than the most you can do.
The troubling trend is the more women are getting bilateral mastectomies because there is a limited understanding on how good the treatment is for DCIS.
Problems after surgery can be important and include long-term pain, disfigurement and lymphedema if the lymph nodes are removed.
Researchers believe that the next step is to create a test that establishes which types of DCIS will become dangerous cancer versus which will not cause any harm at all.