First came questions about the wisdom of treating low-grade prostate cancer. Now comes a major epidemiological study–one that followed 100,000 women for 20 years– that raises similar questions about the effectiveness of treating very early stage breast cancer, known as ductal carcinoma in situ, or D.C. I. S. The New York Times reports that researchers found that women whose early cancer was treated with lumpectomies or mastectomies had a chance of dying of breast cancer in the two decades after treatment of 3.3 percent, no matter which procedure they had, and they also had about the same as an average woman’s chance of dying of breast cancer. How can that be? D.CI.S. has long been believed to be a precursor of potentially deadly cancer. But wait, the researchers argue, if deadly breast cancers started out as D.C.I.S., the incidence of invasive breast cancers should have plummeted with rising detection rates, and it did not. Does that mean that tens of thousand of women are undergoing painful, traumatic and sometimes disfiguring surgeries that are unnecessary. More research, lots of debate, and possibly the re-education of many surgeons, are needed. Read the study here. Read commentary on the study here.
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