If you've been diagnosed with DCIS (ductal carcinoma in situ), the risk of the cancer coming back after surgery is quite low. Still, the study reviewed here found that many women overestimate their risk of DCIS coming back after surgery.
Research shows that the risk of DCIS coming back is less than 10% after lumpectomy and about 1% after mastectomy.
DCIS may be called "pre-cancer" because the abnormal tissue isn't invasive. DCIS stays inside the milk duct of the breast. But DCIS can become invasive cancer if the abnormal tissue isn't removed. Treatment for DCIS is often a lumpectomy, followed by radiation therapy in many cases. Some women may choose to have a mastectomy to treat DCIS. Doctors may recommend a mastectomy instead of lumpectomy for some women who have DCIS in several locations in the breast or if the DCIS is large.
Global efforts to raise awareness and educate women about breast cancer and risk have been very successful. But sometimes this heightened awareness may make women overestimate their breast cancer risk. This heightened awareness also might be part of the reason why women diagnosed with DCIS tend to overestimate their risk of the DCIS coming back. Still, even though some women are overestimating their risk, the number of women getting screening mammograms after age 40 is going down. This is hard to understand. It's also hard to understand why many women treated for early breast cancer don't always get the appropriate follow-up and screening they should, based on their history.
Visit the breastcancer.org pages on DCIS for more information on diagnosis, treatment, and prognosis.
NEW YORK (Reuters Health) - The chances that a noninvasive precancer in the lining of a breast duct will recur after treatment, or become invasive cancer, are very small. However, many women believe that their risk is at least moderate, according to a new report.
The condition, known as ductal carcinoma in situ or DCIS, actually has a local recurrence rate of just 1 percent after mastectomy and less than 10 percent after breast-conserving treatment, the authors explain in the Journal of the National Cancer Institute.
To look into women's perception of the risk, and how that affected their emotional outlook and psychological status, Dr. Ann Partridge, from Harvard Medical School in Boston, and colleagues surveyed 487 women with DCIS at three time points over an 18-month period.
In general, the quality of life of the study participants was good and anxiety levels at the beginning of the survey decreased over time. Nevertheless, 54 percent of the women believed there was at least a moderate chance of DCIS recurrence in the next 5 years, and 68 percent believed there was at least a moderate chance of recurrence in their lifetime.
Thirty-nine percent of women thought they had at least a moderate risk of invasive breast cancer in the next 5 years; 53 percent thought their lifetime risk of invasive cancer was at least moderate.
Women who had higher levels of anxiety were more likely than others to overestimate the risks of recurrence or of developing invasive disease.
"Clinicians who are caring for the increasing number of women who are diagnosed with DCIS should be aware of these inaccurate perceptions and attempt to minimize them," the authors conclude.
They suggest that steps can be taken to explain the risks clearly to women with a diagnosis of DCIS, and to treat undue anxiety.
SOURCE: Journal of the National Cancer Institute, February 20, 2008.
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