A new study has revealed that women diagnosed with the breast condition DCIS (ductal carcinoma in situ) are often confused about the nature of their illness as medical staff are providing mixed messages about the disease and in particular whether it is cancer. The research, which was funded by the charity Breast Cancer Campaign, questioned 45 women about how they felt when they were diagnosed with DCIS and how their experiences changed over time. Some had been told that DCIS was “pre-cancer”, others that it was “early cancer” whilst others were told that it was not cancer.
One reason for this confusion is that although DCIS is a non-invasive condition where the cancer cells are contained in the ducts of the breast there is uncertainty within the medical profession over which ones will progress into invasive breast cancer. The prognosis for women diagnosed with DCIS is excellent but the treatment is similar to the treatment for invasive breast cancer, including mastectomy and possibly radiotherapy and hormone treatment. It is particularly difficult for women to reconcile this with the message that their condition is not life-threatening.
Consultant Breast Surgeon, Mr Simon Marsh, explains this further in his article on benign breast lumps: "DCIS comes in three types: low, medium and high grade depending on how abnormal it is. High grade DCIS is very nearly cancer and would probably develop into proper cancer within a few years. So, if high grade DCIS is removed we are preventing someone from getting the breast cancer they would otherwise have developed. Medium grade DCIS may take a lot longer to develop into cancer and low grade DCIS may never get that far, but we are not sure. If DCIS is found, it will usually be removed."
The Chief Executive of Breast Cancer Campaign, Baroness Delyth Morgan, summarises the dilemma as follows: “A diagnosis of DCIS can leave women confused about their treatment options as currently even clinicians don’t know which cases will progress to invasive breast cancer. For now we must give clearer messages to patients about what their diagnosis means and the potential risks to them if it is left untreated.”
This is a situation where clear communication by doctors and access to independent information is of primary importance. For more information please click here for an informative and plain English article by Consultant Breast Surgeon, Mr Nicolas Beechey-Newman, discussing the pros and cons of breast screening and explains the role of DCIS in breast cancer treatment.
