Guest blog by Yelena Wells

When Yelena Wells was diagnosed with DCIS, she felt intense pressure from doctors to undergo immediate and aggressive treatment for what is essentially a precancerous condition. This experience led Yelena to research deeply and begin questioning the standard medical approach. She is grateful to share her journey and to be part of a community that embraces holistic paths to healing. Yelena hopes to empower other women to make informed decisions and find their own path to health and wholeness.

For decades, women diagnosed with ductal carcinoma in situ (DCIS) have been told they have “stage zero breast cancer,” creating fear and urgency to treat it aggressively. But a growing body of research challenges whether DCIS should even be called cancer in the first place, as treatment does not lower the risk of dying of breast cancer.

The Controversy Over the Name

What’s in a Name – Is DCIS Cancer? and Renaming Ductal Carcinoma In Situ: Would Removing ‘Carcinoma’ Reduce Overtreatment? argue that labeling DCIS as “carcinoma” is misleading. DCIS cells are confined within the milk ducts and have not invaded surrounding breast tissue. By definition, cancer requires invasive properties to spread and threaten life. DCIS does not meet this traditional definition of cancer.

In fact, a 2015 Science Direct qualitative study showed that women’s treatment choices shifted dramatically depending on the terminology used. Calling it “abnormal cells” rather than “carcinoma” reduced anxiety and led to more conservative management preferences. Similarly, Medscape proposed removing “carcinoma” from the name altogether to better reflect its non-invasive nature.

Treatment Has Not Reduced Invasive Cancer Rates

Despite the surge in early detection and aggressive treatment of DCIS over the past 40 years, invasive breast cancer rates have not declined. The Sea of Uncertainty Surrounding DCIS and Diagnosis and Management of DCIS highlight that while DCIS treatments lower local recurrence rates, they do not affect overall breast cancer mortality. As Time reported in 2015, “DCIS treatment reduces recurrence but doesn’t save lives.”

This has led many experts to question why we continue to treat DCIS like cancer when removing it surgically or radiating it has no measurable impact on survival rates.

The COMET Study: A New Approach to DCIS

Perhaps the most promising shift in this debate comes from the recent COMET trial (Comparison of Operative to Monitoring and Endocrine Therapy), which evaluates active surveillance versus surgery for low-risk DCIS. Early findings suggest that women who forgo immediate surgery and choose careful monitoring with or without hormonal therapy fare just as well as those who undergo lumpectomy or mastectomy. This aligns with DCIS: to treat or not to treat? and Treatment of low-risk DCIS: is nothing better than something, both of which question whether doing less could actually be better for patients. Even the National Breast Cancer Coalition defines Ductal Carcinoma In Situ (DCIS) as NOT cancer.

Moving Forward: Rethinking Risk, Terminology, and Treatment

As When Cancer is Not Cancer emphasized, redefining DCIS is not just about semantics; it is about empowering women to make informed decisions without fear-based pressure. The current evidence indicates that DCIS may be a marker of increased risk rather than a pre-cancer needing immediate surgical removal.In 2010, the American Cancer Society and National Cancer Institute held a conference to review current issues in DCIS risk communication and decision-making and to identify directions for future research, including consideration of nomenclature changes.

Understanding DCIS and the language we use to describe it is crucial. Women deserve clarity, not confusion and fear when making decisions about their health.

📝 Articles & Resource Links

• A Major Shift in Breast Cancer Understanding (Time, 2015)
• What’s in a name—is DCIS cancer? From Ductal Carcinoma in Situ: Current Concepts in Biology, Imaging, and Treatment (J Breast Imaging, 2019)  
• Renaming Ductal Carcinoma in Situ: Would Removing “Carcinoma” Reduce Overtreatment? (JNCCN, 2014)
• How different terminology for ductal carcinoma in situ (DCIS) impacts women’s concern and management preferences: A qualitative study (Science Direct, 2015) 
• The sea of uncertainty surrounding ductal carcinoma in situ–the price of screening mammography (J Natl Cancer Inst, 2008) 
• Ductal Carcinoma In Situ , Complexities and Challenges (JNCI, 2004)  
• Ductal carcinoma in situ: to treat or not to treat, that is the question (BJC, 2019)
• Treatment of low-risk ductal carcinoma in situ: is nothing better than something? (The Lancet Oncology, 2016) 
• What is DCIS, and Why Does It Matter? (NBCC Website) 
• When Cancer Isn’t Cancer (N1X10 Pickler, 2025) 
• Challenges in DCIS Risk Communication and Decision-Making: Report from an American Cancer Society and National Cancer Institute Workshop (CA Cancer J Clin, 2014)

🎥 Educational Videos

• Overtreatment of Stage 0 Breast Cancer DCIS (Nutrition Facts, 2018)
• Mayo Clinic Radio: Ductal Carcinoma In Situ (DCIS)
• Understanding DCIS (Wang, 2009)