Breast cancer but no scalpel

29 August 2013 - 02:43 By Reuters
Image: ©Rudyanto Wijaya/

A new survey has suggested that the way in which doctors describe a non-invasive type of breast lesion might affect how women choose to have the abnormal cells treated.

Ductal carcinoma in situ, or DCIS, accounts for about one in every five breast cancer diagnoses in the US. DCIS might spread but is not life-threatening - and some researchers question whether it should be called "cancer".

Nevertheless, most women with DCIS have breast-conserving surgery or a mastectomy. The new findings suggest that the use by doctors of the phrase "non-invasive cancer" to describe DCIS - instead of "breast lesion", for example - might be one reason for women tending to go the surgery route.

"I think it's often the case that patients hear the word 'cancer' and that's all they take in; the 'non-invasive' part is missed," said Elissa Ozanne, who worked on the study at the University of California in San Francisco.

"Having DCIS puts you at higher risk of invasive breast cancer but it's not at all the same as having an invasive cancer", said Heather Gold, a breast cancer researcher at New York University's school of medicine.

For their study, Ozanne and her colleagues asked 394 healthy women what treatment they would choose if diagnosed with a hypothetical condition.

Women were presented with the same table of possible outcomes and treatment options for "non-invasive breast cancer", "breast lesion" or "abnormal cells" - all ways of describing DCIS.

Surgery was the most popular option for "non-invasive breast cancer": just under half picked surgery, only a third active surveillance, which involves regular screening to make sure that the cancer has not become invasive.

Those proportions reversed when the diagnosis was given as a "breast lesion" or "abnormal cells", according to the findings published this week in the Journal of the American Medical Association: Internal Medicine.

Gold, who was not involved in the new study, called it "very timely".

She said women diagnosed with DCIS should discuss the risks with their doctor and make sure they fully understood the intricacies of treating the condition.

Some types of DCIS are very aggressive and can grow quickly, she said. Others typically did not.