E. Shelley Hwang, MD, MPH
The routine use of screening mammography has drastically increased the identification of ductal carcinoma in situ (DCIS) over the past 3 decades. However, results from current research suggest that many cases of DCIS have a low risk for progression and thus may not require surgical excision and radiation therapy.
TABLE. Change in Size-Specific Incidence of Breast Cancer After Introduction of Screening Mammography
Surgery or Radiation for Low-Grade, Low-Recurrence Score DCIS?
Although early detection of DCIS enables patients to receive treatment before the cancer becomes invasive, Anees B. Chagpar, MD, MSc, MPH, MA, MBA, pointed out that some patients are treated for low-grade precancerous lesions that probably would not develop into invasive cancers or affect longevity. “If they had never known about those lesions, they could have just as well lived their life,” said Chagpar, associate professor in the Department of Surgery at the Yale School of Medicine and the assistant director for global oncology at the Yale Comprehensive Cancer Center. “Now they are undergoing all kinds of treatments for these lesions, and is that really necessary?”
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