Women with DCIS Breast Cancer Uncertain About Risk of Recurrence

Posted on March 8th, 2009 by

Women with DCIS Breast Cancer Uncertain About Risk of Recurrence

Women diagnosed with ductal carcinoma in situ (DCIS), the earliest stage of breast cancer, tend to have inaccurate views on their risks of recurrence following treatment. These results were recently published in the Journal of the National Cancer Institute.

Ductal carcinoma in situ (DCIS) is the earliest stage of breast cancer, during which the cancer is small and confined to an area within a duct of the breast. Previously, DCIS was often considered a “pre-cancerous” condition that had the potential to turn into cancer. Nowadays, however, DCIS is largely accepted as an early stage of breast cancer and is treated accordingly.

Depending upon the size and aggressiveness of DCIS, patients may undergo surgery in addition to radiation therapy or hormone therapy. Some patients opt for complete removal of the breast affected by DCIS (mastectomy), while others choose the surgical removal of DCIS and surrounding tissue (breast-conserving therapy).

Cancer recurrences outside the breast occur in approximately 1% of patients with DCIS. Recurrences near the site of origin occur in approximately 1% of patients who undergo a mastectomy, and less than 10% of those who undergo breast-conserving therapy. Although the statistics represent low recurrence rates, patient response and personal outlook when diagnosed with DCIS is not well known.

Researchers from Boston and North Carolina recently conducted a clinical study to evaluate risk perceptions, emotional concerns, and health behaviors among women newly diagnosed with DCIS. This study included 487 women in Eastern Massachusetts who completed a survey regarding these issues at nine and 18 months following their diagnosis. Findings showed that the women estimated that their risk of recurrence was much higher than statistics indicate:

  • Overall quality of life was reported to be good among patients.
  • Substantial anxiety regarding the diagnosis of DCIS decreased with time.

The first survey demonstrated the following results:

  • 54% of women thought they had at least a moderate risk of DCIS recurrence during the next five years.
  • 68% of women believed this risk of recurrence remained throughout their lifetime.
  • 39% of women believed they had at least a moderate risk that DCIS would become more invasive within the breast in the next five years.
  • 53% of women believed this risk remained throughout their lifetime.
  • 28% believed they had at least a moderate risk of DCIS spreading to other sites of the body.

At 18 months these perceptions had not significantly changed. It was noted that these perceptions were associated with anxiety.

The researchers concluded that women with DCIS tend to significantly overestimate their risks of a cancer recurrence and/or spread of cancer from its site of origin. The authors state that “Many women with newly diagnosed DCIS have inaccurate perceptions of the breast cancer risks that they face, and anxiety is particularly associated with these inaccurate perceptions.”

Women diagnosed with DCIS may wish to discuss their diagnosis and subsequent risks of recurrences with their healthcare provider.

Reference: Partridge A, Adloff K, Blood E, et al. Risk perceptions and psychosocial outcomes of women with ductal carcinoma in situ: longitudinal results from a cohort study. Journal of the National Cancer Institute [early online publication]. February 12, 2008. DOI: 10.1093/jnci/djn010.

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