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Study Suggests Some Treatment For Early Breast Cancer Is Unnecessary


What many doctors consider to be a very early form of breast cancer may not be as risky as once thought. That's what's suggested in a new study out today. NPR's Rob Stein reports that the findings are the latest indication that some women are getting unnecessary treatment for breast cancer.

ROB STEIN, BYLINE: When thousands of women get the results of their mammograms, they get what sounds like really scary news. They have something called ductal carcinoma in situ, or DCIS for short. But Otis Brawley of the American Cancer Society says there's a big debate about what DCIS really is.

OTIS BRAWLEY: It is considered by certain groups to be an early cancer. It's considered by other groups to be a precancerous lesion. And it's considered by yet a third cohort of groups to be a risk factor for cancer.

STEIN: In other words, it may not be cancer at all or ever turn into cancer. Despite the debate, women who get diagnosed with DCIS end up getting treating pretty aggressively. At the very least, they get surgery to remove the lump. A lot also then get radiation and take powerful hormonal drugs. An increasing number are going even further - getting a mastectomy to remove the entire breast.

BRAWLEY: Many women who have DCIS are choosing not to just to get a mastectomy, but to get a bilateral mastectomy and have both breasts removed.

STEIN: But the new study's raising big questions about all that. In this week's issue of the journal JAMA Oncology, Canadian researchers analyzed what happened to more than a hundred-thousand women who were diagnosed with the DCIS.

BRAWLEY: What this paper found is, the group of women who had ductal carcinoma in situ, if you look at them over 10 to 20 years, the number who have cancer and the number who die from cancer is actually very similar to women who were never diagnosed with this entity.

STEIN: So DCIS may not be so dangerous after all. Now, no one is saying that means women can just ignore it. At the moment, Brawley and others say women should still get it removed. But for many, they could stop there - no radiation, no hormonal drugs and certainly no mastectomies.

LAURA ESSERMAN: You know, I think the most important thing people should understand is that DCIS is not an emergency.

STEIN: Laura Esserman is a breast cancer expert at the University of California, San Francisco.

ESSERMAN: People are told that they have to get something done in two weeks. I mean, you could take a year, and nothing bad's going to happen.

STEIN: Now, it's important to note that DCIS is clearly riskier for some women, like those who get it when they're younger and black women, but scientists hope they'll eventually figure out whether some women can just keep an eye on DCIS and end up doing nothing at all. Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.