Precancer? Earliest cancer? Milk-duct cells vexing

Sep 24, 2009 By LAURAN NEERGAARD , AP Medical Writer

(AP) -- Some doctors tell patients they have "stage zero" breast cancer. Others call it a precancer.

A less scary formal name could help, says a new report that urges removing the word "carcinoma" from the diagnosis of a common growth in milk ducts.

More than 50,000 women a year are diagnosed with DCIS, or in situ. This is not , the kind that kills. The abnormal cells haven't left the milk duct to penetrate breast tissue.

Still, it's removed because it is a risk factor for developing true invasive cancer later. Treatment works. Only about 2 percent of DCIS patients die of breast cancer in the next 10 years.

The problem: Doctors don't have a good way to tell which women are at risk of DCIS returning as true cancer and which aren't. So there are vast differences in how it's treated, from a simple small surgery to a full radiation-and-chemo blast. Some women even have the healthy opposite breast removed protectively.

It's time for major research to answer the risk question and determine who could safely skip harsh treatment and who really needs it, concluded specialists convened by the National Institutes of Health to assess DCIS.

And changing the name, the panel concluded, will help doctors convey that while this growth shouldn't be ignored, there's time to carefully consider the options.

"The name carries with it such a disproportionate level of anxiety relative to the relatively indolent nature of the disease," said Dr. Carmen Allegra, a University of Florida oncologist who chaired the panel.

The panel didn't offer an alternative name.

But the issue is similar to , where abnormal cells form on the surface of the cervix before eventually invading. What doctors now call a precancerous condition - and classify with various levels of severity - they once termed cervical carcinoma in situ.

With DCIS, "this is a complex area we know less about," said Dr. Susan Reed of Seattle's Fred Hutchinson Cancer Research Center. "We don't have a clear understanding of how to say, for example, 'Mrs. Jones, your risk to get an invasive in the next 10 years would be' some percentage."

©2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Explore further: New study helps to explain why breast cancer often spreads to the lung

add to favorites email to friend print save as pdf

Related Stories

MRI finds breast cancer before it becomes dangerous

Aug 10, 2007

A study in the Lancet (vol. 370, 11 August 2007) could lead to a change of paradigm in the early diagnosis of breast cancer. It states that magnetic resonance imaging (MRI) is substantially more accurate than mammography in dia ...

Recommended for you

US OKs first-ever DNA alternative to Pap smear (Update 2)

9 hours ago

U.S. government health regulators have cleared a genetic test from Roche as a first-choice screening option for cervical cancer. It was a role previously reserved for the Pap smear, the decades-old mainstay of women's health.

New breast cancer imaging method promising

14 hours ago

The new PAMmography method for imaging breast cancer developed by the University of Twente's MIRA research institute and the Medisch Spectrum Twente hospital appears to be a promising new method that could ...

Palliation is rarely a topic in studies on advanced cancer

15 hours ago

End-of-life aspects, the corresponding terminology, and the relevance of palliation in advanced cancer are often not considered in publications on randomized controlled trials (RCTs). This is the result of an analysis by ...

User comments : 0

More news stories

Genetic code of the deadly tsetse fly unraveled

Mining the genome of the disease-transmitting tsetse fly, researchers have revealed the genetic adaptions that allow it to have such unique biology and transmit disease to both humans and animals.