Is it any wonder that she and thousands of women like her are racing to the operating room to amputate both their breasts?
Why such radical treatment for DCIS?
“Right now, we have women getting bilateral mastectomies for ductal carcinoma in situ (DCIS), which is not a cancer,” Otis Brawley, chief medical officer of the American Cancer Society, said. “It’s the world turned upside down.”
“There’s a hysteria around breast cancer. The extremism that sometimes comes into play in DCIS treatment decision making is a ‘cultural problem.’ This is not a life-threatening problem.” – Dr. Anne Partridge, MD, MPH, Dana-Farber Cancer Institute
Experts are working to remove the word “CARCINOMA.”
“Use of the term ‘cancer’ should be reserved for describing lesions with a reasonable likelihood of lethal progression if left untreated.” DCIS is not such a lesion, according to a report issued by a National Cancer Institute working group. A less threatening term they suggest is “indolent lesion of an epithelial origin.”
“DCIS is not invasive cancer so why are we treating it as if it is?”– Dr. Laura Esserman, Director of the Carol Franc Buck Breast Care Center, UCSF
Debunking the theory that DCIS is early cancer destined to progress.
Even though more than 60,000 new DCIS cases are being treated each year (in the US alone), there has been no corresponding decrease in the rate of invasive breast cancer. This suggests that there has been little or no value in treating DCIS as if it were early cancer, according to Laura Esserman, co-author of an essay published in the Journal of the American Medical Association which made a forceful case for the name change and for a less aggressive approach toward treating DCIS.
Early detection does NOT save lives.
Studies have proven the fundamental philosophy behind “early detection” is flawed. Not only do mammograms harm thousands of lives every year, they miss 20-25% of the really serious invasive cancers. Joan Lunden’s aggressive cancer was missed by a mammogram. It was found on an ultrasound.
Mammograms cause OVER-diagnosis and OVER-treatment of DCIS.
A study in Norway estimates that 15 – 25 % of breast cancers found by mammograms wouldn’t have caused any problems during a woman’s lifetime, but these tumors were being treated anyway, often by being surgically removed and sometimes treated with radiation or chemotherapy, (because there’s no certain way to figure out which ones may be dangerous and which are harmless).
Yet still, Sandra Lee stated in People Magazine, “My doctor called me a poster girl for mammography.” Now she is urging women as young as in their 20’s and 30’s to get their mammograms.
What Sandra Lee doesn’t realize…
Her life was not saved by a mammogram. Her life was harmed by it.
Young women especially need to be cautious.
Young women tend to have dense breast tissue. Mammograms are harmful — not beneficial. Routine mammograms in young women also increase the risk for future breast cancer due to direct radiation exposure to breast tissue. For young women who have a high risk of breast cancer because of genetic mutations, the radiation from yearly mammograms may make the risk even higher. Read more here.
Radical treatments, fear, anxiety and financial hardship — all for what?
“We are curing people who don’t need to be cured,” Dr. Otis W. Brawley, chief medical officer of the American Cancer Society, told WebMD.
Women like Sandra Lee are “battling” something that doesn’t need to be battled. She is a poster girl for “over-diagnoses” and “over-treatment” — treated for breast cancer unnecessarily — as explained in a NY Times article Cancer Survivor or Victim of Overdiagnosis.
Mammograms open a can of worms that is better left unopened.
Too many women like Sandra Lee are facing harsh choices — to chop off their breasts — or to live in fear of a “ticking time bomb.” Once diagnosed with DCIS, women are paralyzed with this fear — and the choices given to them are inappropriately aggressive, harmful and costly. The alternative to mastectomy — a lumpectomy plus several weeks of daily radiation — also comes with harms, future worries, on-going surveillance and a high rate of failure.
DCIS surgery (lumpectomies) often FAIL — leading to multiple surgeries and mastectomies.
Studies have shown 48% to 59% of women with DCIS surgery require a 2nd or 3rd surgery due to “positive margins.” It is a problem inherent in the current DCIS treatment methodology — and ineffective lumpectomies are leading more and more women with DCIS (even low grade) to lose their breasts. “Although DCIS can be initially diagnosed with microcalcifications on a mammogram, the calcifications do not outline the whole area of involvement. There is no imaging tool that can tell the surgeon how much DCIS is present before the surgery, and a surgeon cannot see it or feel for it during the surgery.” – Dr. Susan Love
More harms that women are left in the dark about.
Prior to an open biopsy or lumpectomy, a procedure called wire localization is required in order to “guide” a surgeon in what in essence is a “blind surgery.” A wire is pierced through a women’s breast then the breast is smashed and radiated in a mammogram machine. This procedure is painful, ineffective, harmful and barbaric. One does not need to have a medical degree to realize this is damaging to sensitive breast tissue. And the real frustrating part is it is a total failure 48 – 59% of the time (as stated above)!
Harms of radiation and tamoxifen are downplayed while benefits are exaggerated.
Imagine being told that after you have these invasive procedures and surgeries (which often fail), you will need 5-7 weeks of daily radiation therapy plus five years of a highly toxic drug called tamoxifen — both of which Dr. Michael Lagios, internationally recognized breast pathologist says are of little benefit. “It is understandable that patients would be confused by the information and misinformation, but the fact remains that radiation therapy for DCIS has a limited role, and that tamoxifen has no certain role at all.”
Radiation therapy and tamoxifen are carcinogenic, meaning they can cause cancer. In addition, they both have harmful side-effects, create severe psychological trauma, financial hardship and can increase mortality! Yet, these are one-size-fits-all “standard of care” treatments for DCIS.
The treatment of DCIS is appalling.
“The time is now to discuss a change in the approach to DCIS. We should be demanding change.” – Dr. Laura Esserman
No doctor should tell a woman that she is a “ticking time bomb.”
If at any time you (or someone you know) feels pressured, rushed, bullied, or coerced to have aggressive treatment for DCIS, please reach out for support (see Facebook groups below).
Women deserve better.
As Dr. Esserman stated, women need to demand change. The only way to do this is by being fully informed. Here are 10 very important things women really need to know to avoid excessive, costly, invasive physical treatments and traumatic emotional harm:
1. Mammograms contribute to the radical over-treatment of DCIS. See the promise film: The truth about the routine breast screening program. Read Bye-Bye Mammograms — Hello SonoCine. Evaluate alternative screening and surveillance choices here.
2. DCIS is NOT invasive cancer. Read more on this topic here.
3. “DCIS is not an emergency. It’s something that creates an environment where cancer may arise over the next 10-20 years, yet patients are being told they need surgery in the next fortnight.” -Dr. Laura Esserman, Director of the UCSF Breast Care Center
4. Women can save their breasts! If you are told your only option is a mastectomy, Dr. Melvin Silverstein and other surgeons offer oncoplastic techniques with lumpectomies. Another option is “nipple sparing mastectomy.”
5. A 2nd pathology opinion from an expert pathologist such as Dr. Michael Lagios is a MUST! It can change the course of treatment and bring peace of mind with challenging decisions.
6. DCIS is heterogeneous in nature. Treatment should not be “one-size-fits-all” — it must be individualized. The The Van Nuys Prognostic Index offers a more tailored prognosis. It is based on size & grade of DCIS, margins and age of patient. Oncotype DX is the first clinically validated commercial genomic assay which reveals the underlying biology that can help guide DCIS treatment decisions by predicting the risk of any local recurrence of DCIS and the risk of invasive cancer.
7. Active surveillance is a reasonable option for low grade DCIS.
8. In addition to SonoCine Automated Whole Breast Ultrasound, Dedicated breast MRI is a highly accurate and useful surveillance tool, especially for DCIS. It’s 1% false negative rate means there is only a 1% chance that it will miss invasive cancer compared to whole body MRI with a 15% false negative rate.
9. Life-style strategies can increase breast health and reduce breast cancer risk or recurrence. Join the Proactive Breast Health Club and receive periodic articles.
10. Support is vital. Just a few years ago, DCIS support groups were nonexistent (especially for women questioning the “standard of care.”) Today, thanks to the internet and Facebook, hundreds of women world-wide are connecting and sharing experiences, emotions and insights. Topics include both conventional and “alternative” treatments, surveillance, healing foods, supplements, stress reduction and healthy life-style habits. Please click the links and “join” the Facebook groups below: