Celebrity chef Sandra Lee was told by her doctors she was “a ticking time bomb.”
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.
What is causing 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.
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 often 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 micro-calcifications 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 unacceptable.
“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 #beWISE tips for women to avoid excessive, costly, invasive physical treatments and traumatic emotional harm:
1. Mammograms contribute to the radical over-treatment of DCIS.
2. DCIS is NOT invasive cancer and 70-80% may be harmless. Read more 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 do not need to amputate their breasts! If you are told your only option is a mastectomy, Dr. Melvin Silverstein and other surgeons offer oncoplastic techniques with lumpectomies.
5. A 2nd pathology opinion from an expert pathologist is a must. Listen to my phone consultation with Dr. Michael Lagios. A 2nd opinion 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. “DCIS — Beyond One Size Fits All” provides valuable resources.
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:
KPBS Radio & TV, August 24, 2015, Study Prompts San Diego Doctors, Patients To Question Breast Cancer Treatment Strategy TOP STORY on Midday Edition — a LIVE 16 minute radio interview and 5 minute TV segment featuring Donna along with an oncologist from Sharp Hospital in San Diego.
TIME Magazine, October 1, 2015: Why Doctors Are Rethinking Breast-Cancer Treatment Donna was interviewed via phone for 45 minutes for this article. She discussed how she was “blindsided” when given the diagnosis, yet she knew intuitively the standard aggressive DCIS protocol was not right. Sadly, this article focuses on “doing nothing” and does not mention being pro-active with regards to a holistic approach to diet and lifestyle as Donna emphasized was so important for herself as well as all women choosing “active surveillance.”
San Diego Union Tribune, Study challenges status quo in breast cancer treatment Donna’s story is featured in this FRONT PAGE article.
ABC’s Good Morning America, August 21, 2015:
JAMA Oncology, Editorial, October 2015: Rethinking the Standard for Ductal Carcinoma In Situ Treatment
Health News Review, DCIS dilemma: Dr. Laura Esserman podcast
Prevention Magazine, Nov 5, 2015: Annual Mammograms Won’t Lower Your Risk Of Dying From Breast Cancer. Here’s What Will.
Los Angeles Times, November 20, 2015: We should look less hard for cancer
Elle Magazine, June 8, 2015: THE DANGER OF DCIS, THE BREAST “CANCER” THAT’S OFTEN NOT
DCIS 411 