Older Women Diagnosed With DCIS or Early-Stage Disease Have Excellent Prognosis
A large study found that women older than 67 diagnosed with either DCIS or stage I breast cancer were just as likely to be alive 10 years after diagnosis as women not diagnosed with breast cancer.
A large study found that women older than 67 diagnosed with either ductal carcinoma in situ (DCIS) or stage I breast cancer were just as likely to be alive 10 years after diagnosis as women not diagnosed with breast cancer.
Older women diagnosed with stage II, stage III, or stage IV breast cancer were less likely to be alive 10 years after diagnosis compared to women not diagnosed with breast cancer. The research was published in the Journal of Clinical Oncology.
DCIS is not invasive cancer. DCIS stays inside the breast milk duct. DCIS can be large or small, but it doesn't spread outside the milk duct into the surrounding normal breast tissue or into the lymph nodes or other organs. Still, a woman diagnosed with DCIS is at higher risk of developing invasive breast cancer in the same breast compared to someone who hasn't had DCIS. DCIS also is referred to as stage 0 breast cancer.
Women diagnosed with DCIS have very good prognoses. Ten years after DCIS diagnosis, 98% to 99% of women will be alive. Based on this good prognosis, DCIS usually is treated by lumpectomy followed by radiation therapy. If the DCIS is large, a mastectomy may be recommended. Chemotherapy usually isn't recommended following surgery for DCIS. Hormonal therapy may be recommended if the DCIS is hormone-receptor-positive.
Stage I is the earliest stage of invasive breast cancer. Invasive means that the cancer cells are invading neighboring normal tissue. Stage I breast cancers are 2 centimeters or smaller (a little bigger than 0.75 inches) and have not spread to the lymph nodes.
Women diagnosed with stage I breast cancer also have good prognoses. Stage I breast cancer is treated by lumpectomy followed by radiation therapy. Depending on the circumstances, a mastectomy may sometimes be recommended. Because stage I breast cancer can come back (recur), chemotherapy is sometimes given after surgery (treatments given after surgery are called adjuvant treatments). Adjuvant hormonal therapy may be recommended if the cancer is hormone-receptor-positive. The targeted therapy Herceptin (chemical name: trastuzumab) also may be recommended if the cancer is HER2-positive.
The researchers compared the health outcomes of two groups of women:
- 64,894 women diagnosed with either DCIS or invasive breast cancer
- 64,894 similar women who weren't diagnosed with breast cancer
The women diagnosed with breast cancer were matched to the healthy women. This means the researchers made sure that the diagnosed women were very similar in factors such as age, general health, lifestyle, and where they lived to the women who weren't diagnosed.
Half the women were older than 76 and the other half were younger. All the women were older than 67. The women were followed for about 8 years. The researchers projected 10-year survival rates for all the women and compared the projected survival rates of women diagnosed with DCIS or invasive breast cancer to the rates of women not diagnosed with breast cancer.
Women diagnosed with DCIS were 10% more likely to be alive after 10 years compared to women not diagnosed with breast cancer.
Women diagnosed with stage I breast cancer were just as likely to be alive after 10 years compared to women not diagnosed with breast cancer.
Women diagnosed with stage II, III, or IV breast cancer were less likely to be alive after 10 years compared to women not diagnosed with breast cancer:
- women diagnosed with stage II breast cancer were 15% less likely to be alive
- women diagnosed with stage III breast cancer were 55% less likely to be alive
- women diagnosed with stage IV breast cancer were 88% less likely to be alive
In this study, the good outcomes of women diagnosed with DCIS or stage I breast cancer are probably because most of the women received the right treatment at the right time. The results underscore the value of regular screening mammograms to detect DCIS and invasive breast cancer in older women.
Regular screening mammograms starting at age 40 help diagnose breast cancer early, when it's most treatable. Research has shown that screening mammograms save lives. So if you're 60, 70, 80, or somewhere in between and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, it's a good idea to ask your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.
There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of regular screening mammograms.
If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.
For more information on mammograms and other tests to detect breast cancer, visit the Breastcancer.org Screening and Testing section.
— Last updated on February 22, 2022, 9:53 PM
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