{"id":7253,"date":"2015-08-24T18:51:40","date_gmt":"2015-08-24T23:51:40","guid":{"rendered":"https:\/\/wholehealthchicago.com\/?p=7253"},"modified":"2021-08-17T22:26:20","modified_gmt":"2021-08-18T03:26:20","slug":"some-good-news-about-dcis-and-worrisome-mammograms","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2015\/08\/24\/some-good-news-about-dcis-and-worrisome-mammograms","title":{"rendered":"Some Good News About DCIS and Worrisome Mammograms"},"content":{"rendered":"\n

I\u2019ve lost track of the number of women who\u2019ve told me something like this: \u201cMy mammogram experience was horrible. They called me back with this get-in-here-right-away sense of urgency. I was terrified. They took lots of pictures, talked about calcifications. I had one biopsy, then had to return for another. The suspense was horrible.\u201d<\/p>\n\n\n\n

And after the biopsy\u2026<\/p>\n\n\n\n

\u201cI was told I had DCIS (ductal carcinoma in situ) and that it\u2019s really not the same as breast cancer, but it needed to be removed anyway because having DCIS increased my risk for regular breast cancer. I had the lumpectomy, then radiation. One doctor suggested chemotherapy, another recommended removing both breasts. I said no, but now I go back every few months for a recheck. And I think about this all the time.\u201d<\/p>\n\n\n\n

It\u2019s helpful to know a few things about DCIS. First, it\u2019s not the same as the invasive breast cancer that\u2019s the second leading cause of US cancer deaths among women (after lung cancer). Invasive means it can invade (spread to) other tissues in the body.<\/p>\n\n\n\n

\u201cIn situ\u201d is Latin for \u201cin place,\u201d meaning the cancer cells have not spread to nearby healthy breast cells. Yes, it would be clearer if they\u2019d dropped the \u201cin situ\u201d and simply referred to it as non-invasive. <\/em><\/p>\n\n\n\n

You might be surprised to learn that DCIS is a relatively new condition. Since it\u2019s virtually never felt as a breast lump (it\u2019s too tiny), doctors became aware of it only with an increase in screening mammograms. Physicians saw calcium clumps, most of them completely benign and of no significance. Other calcifications contained cancer cells apparently trapped inside a milk duct.<\/p>\n\n\n\n

The big question was how to judge the significance of these cancer cells and what the future held for a woman with DCIS. When doctors first started seeing DCIS on mammograms, it was regarded as an early stage of cancer and treated very aggressively. This meant surgery (lumpectomy or mastectomy) and radiation therapy and possibly taking hormone-blocking agents (more on these below).<\/p>\n\n\n\n

Some doctors suggested bilateral mastectomy (surgical removal of both breasts) and others chemotherapy, the latter quickly discounted because by definition there was no evidence of cancer spread.<\/p>\n\n\n\n

Some reassuring good news appears<\/strong><\/h3>\n\n\n\n

The good news about worrisome mammograms<\/a> and DCIS was published this week in JAMA Oncology<\/a><\/em>, which reported on an immense 20-year study that tracked what actually happened to 100,000 women diagnosed with DCIS. The top take-aways about breast calcifications and DCIS are:<\/p>\n\n\n\n