31 Days of “Little Known” FACTS — For Breast Cancer Awareness Month — Day 30 — NO “Survival” Benefit of Aggressive Treatments for DCIS — Women Not Informed

Did you know…

Women diagnosed with DCIS, also known as “stage ZERO” breast cancer, are often rushed into extremely aggressive treatments (surgery, radiation and drugs) that actually have no survival benefit… yet this information is often not told to them.

Instead women are given confusing “risk reduction” statistics with each of the “standard of care” treatments. Emphasis is purely on decreasing a woman’s risk of a future DCIS or invasive cancer. The percentages used are often misleading as the #s may be relative risk #s rather than absolute #s.

In addition, side effects of all the treatments are downplayed.

Dear Healthcare Providers:

Women deserve to be fully informed about all potential side effects of each treatment as well as the survival benefit for each treatment.

Evaluating DCIS treatments — do you know your “survival” statistics? is a compilation of studies with conclusive evidence of no survival benefit for the treatments commonly recommended for all types of DCIS (even low-risk):

“There is strong evidence that treatment of DCIS in most women has no clear effect on mortality reduction.” – Finding the balance between over- and under-treatment of ductal carcinoma in situ (DCIS)

“Risk of development of metastases and/or death in a patient diagnosed with pure DCIS is very low (<1%).Ductal Carcinoma-In-Situ of the Breast with Subsequent Distant Metastasis and Death

SURGERY

RADIATION

  • “Radiation for DCIS is prophylactic; it reduces the risk of invasive recurrence, the only lethal form of breast cancer, while increasing the probability of eventual mastectomy. The absolute magnitude of both effects is modest, such that personal patient preferences should drive decision-making. – Radiation therapy for ductal carcinoma in situ: A decision analysis

TAMOXIFEN

  • While tamoxifen after local excision for DCIS (with or without adjuvant radiotherapy) reduced the risk of recurrent DCIS (in the ipsi- and contralateral breast), it did not reduce the risk of overall mortality. – Postoperative tamoxifen for ductal carcinoma in situ.

  • Warrick and Allred in their editorial piece conclude that tamoxifen is probably overused, and advocate more selective use. They particularly note that the major benefit would be seen in patients who are younger (premenopausal) with extensive high grade disease and/or narrow margins, and clearly only those that are ER positive. In conclusion, the clinical benefit of tamoxifen intervention based on the randomized trials is meager at best. There appears to be no benefit, at least in the UK/ANZ trial for tamoxifen amongst irradiated patients, and the benefits when claimed are very small. – Tamoxifen as an Adjuvant Agent for Ductal Carcinoma In Situ (DCIS)

About Donna Pinto

I am originally from New Jersey and moved to Los Angeles with my family at age 12. After graduating from San Diego State University with a BA in Journalism, I had a short-stint in magazine advertising sales before landing my "dream job" with Club Med. For two years I worked at resorts in Mexico, The Bahamas, The Dominican Republic and Colorado. My husband Glenn & I met in Ixtapa, Mexico and we embarked on a two year honeymoon around the world. This was also a research project for a book we wrote called "When The Travel Bug Bites: Creative Ways to Earn, Save and Stay Abroad." I am also the author of a quote book for new graduates -- "Cheatnotes on Life: Lessons From The Classroom of Life." In 1997, we settled in San Diego and I was blessed to work part-time from home for non-profit organizations while raising our two boys. In 2010, a DCIS diagnosis changed my life. DCIS 411 is the culmination of my on-going journey and discoveries.
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