|Panel Urges Further Research to Determine which DCIS Patients may be Candidates for Less-Invasive Therapy|
Ductal carcinoma in situ (DCIS), the most common non-invasive lesion of the breast, presents unique challenges for patients and providers largely because the natural course of the untreated disease is not well understood. Because most women diagnosed with DCIS are treated, it is difficult to determine the comparative benefits of different treatment strategies versus active surveillance, meaning systematic follow-up. An NIH panel is urging more research to determine which DCIS patients may be candidates for less-invasive therapy.
Balintfy: An independent panel convened by the NIH is urging the scientific community to identify appropriate diagnostic factors to better predict the risk of developing breast cancer in women with ductal carcinoma in situ, also called DCIS.
Dr. Allegra: DCIS represents a spectrum of abnormal cells that happen to be confined to the breast duct.
Balintfy: Dr. Carmen Allegra, panel chair and Chief of Hematology and Oncology at the University of Florida, explains DCIS.
Dr. Allegra: The disease is a risk factor for evasive breast cancer but itís important to understand that it is not evasive breast cancer. Itís totally confined to the duct system.
Balintfy: DCIS, the most common non-invasive lesion of the breast, presents unique challenges for patients and health-care providers largely because the natural course of the disease if left untreated is not well understood.
Dr. Allegra: Despite having had a century of knowledge about the disease, we do not understand the natural history of DCIS, and probably never will. And thatís primarily because just about everyone who is diagnoses with DCIS undergoes some form of therapy in general that leads to surgical intervention.
Balintfy: Dr. Allegra recommends determining which individuals are likely to develop invasive breast cancer and which will not. He adds that being able to predict this might save some women from undergoing unnecessary invasive treatments while achieving the same positive outcomes.
Dr. Allegra: Given that the outcomes in women treated with the available therapies is truly excellent with survivals in the 98 percent survival range, the primary question for future research we felt, had to focus on the accurate identification of patient subsets diagnoses with DCIS who may be managed with less therapeutic intervention that we currently use. But at the same time, without sacrificing the excellent outcomes presently achieved with available therapeutics.
Balintfy: The panel also emphasized the importance of patient preferences, and recommended improved communication between patients and providers. Serious consideration was also given to giving DCIS a new name that more closely reflects the excellent survival rates for this condition. For more information on panel's state-of-the-science statement visit the website consensus.nih.gov. This is Joe Balintfy, National Institutes of Health, Bethesda, Maryland.