 5/06 UPDATE: Lumpectomy as good as Mastectomy with DCIS - see study below (click on section) 1/04 UPDATE: Another study confirms that there is NO value in axillary node dissection with DCIS. Ann's NOTE: FDA issued warnings and had Astra Zeneca (maker of Tamoxifen/Novaldex) on dangers of this drug for women with DCIS. The risks have been rated much higher. Please note this and have a full and frank discussion with your doctor if s/he suggests the use of Tamoxifen after diagnosis. Do not allow casual OVERTREATMENT. There may be serious health repercussions. The following comes from the FDA site MEDWATCH (5/15/02): http://www.fda.gov/medwatch/SAFETY/2002/safety02.htm#nolvad Nolvadex [tamoxifen citrate] Audience: Oncologists and other healthcare professionals caring for women with breast cancer FDA and AstraZeneca added a boxed warning and strengthened the WARNINGS section of the label to inform healthcare professionals about new risk information of particular relevance to women with ductal carcinoma in situ [DCIS] and women at high risk for developing breast cancer and are receiving or considering Nolvadex therapy to reduce their risk of developing invasive breast cancer. Mortality Among Women With Ductal Carcinoma In Situ of the Breast in the Population-Based Surveillance, Epidemiology and End Results Program Virginia L. Ernster, PhD; John Barclay, MS; Karla Kerlikowske, MD; Heather Wilkie, BA; Rachel Ballard-Barbash, MD Background Over 14% of breast cancers diagnosed in the United States annually are ductal carcinomas in situ (DCIS). There are no published population-based reports of the likelihood of breast cancer death among US women with DCIS. Methods We used data from the Surveillance, Epidemiology and End Results program to determine the likelihood of breast cancer death at 5 and 10 years among US women aged 40 and older diagnosed with DCIS from 1978 to 1983 (before screening mammography was common; n=1525) and from 1984 to 1989 (when screening mammography became common; n=5547). We also calculated standardized mortality ratios (SMRs) to compare observed deaths from breast cancer, cardiovascular disease, and all causes combined among women with DCIS with deaths expected based on general population mortality rates. Results Among women diagnosed with DCIS from 1978 to 1983, 1.5% died of breast cancer within 5 years and 3.4% within 10 years. Among women diagnosed from 1984 to 1989, 0.7% died of breast cancer within 5 years and 1.9% within 10 years. Relative to the general population, risk of breast cancer death was greater for women diagnosed from 1978 to 1983 (SMR, 3.4; 95% confidence interval [CI], 2.5-4.5) than for women diagnosed from 1984 to 1989 (10-year SMR, 1.9; 95% CI, 1.5-2.3). Women diagnosed from 1984 to 1989 were significantly less likely than women in the general population to have died of cardiovascular diseases (10-year SMR, 0.6; 95% CI, 0.5-0.7) or of all causes combined (SMR, 0.8; 95% CI, 0.7-0.8). Conclusions Among women diagnosed with DCIS, risk of death from breast cancer was low, at least within the 10 years following diagnosis. This may reflect the effectiveness of treatment for DCIS, the "benign" nature of DCIS, or both. At 10 years, women diagnosed from 1984 to 1989 were less likely than women diagnosed from 1978 to 1983 to have died of breast cancer, and their risk of dying of all causes combined was lower than that in the general population. Arch Intern Med. 2000;160:953-958 Ann's NOTE: The conclusion here is enough to make anyone an ADVOCATE. All these years DCIS has been treated with a mastectomy. Even years after lumpectomy was shown to be good for invasive cancer, women with a much lesser disease were getting more extensive surgery. STUDIES MUST BE DONE FOR DCIS. We have just posted a patient perspective where lumpectomy is critized as the wrong treatment (3/02) |
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