‘Stage 0′ breast cancer increases death risk slightly, study suggests

The early stage breast cancer that they studied is ductal carcinoma in situ (DCIS), a small, localized cluster of cancer cells. Celebrity chef Sandra Lee is perhaps the best known women to recently come forward with a diagnosis. About 20 to 25 percent of breast cancers that mammogram screening detects are DCIS. We find and treat these cases now because there’s a general belief that – even though they aren’t usually thought of as potentially fatal themselves – DCIS is a precursor to future invasive cancer.

The large numbers lend confidence to the findings.

The research paper, which was published today in JAMA Oncology, also describes how radiotherapy and mastectomy prevented recurrence but did not diminish breast cancer mortality rates.

Researchers found that for all but a minority of young women diagnosed with DCIS, those treated aggressively with mastectomies or lumpectomies in combination with radiation were no less likely than women on average to die of breast cancer after 20 years.

They write that this is 1.8 times higher than the general population’s risk of dying from breast cancer in that same period, but still a low mortality rate overall.

CHICAGO (AP) – New research shows that chances of dying from very early breast cancer are small but the disease is riskier for young women and blacks, the same disparities seen for more advanced cancer.

Standard DCIS treatment is lumpectomy followed by radiation, although some women choose to have the entire breast or even both breasts removed. Narod’s team concluded that DCIS has more in common with invasive breast cancers than previously thought, because localized treatments such as lumpectomies, mastectomies and radiation therapy don’t appear to have a significant impact on mortality.

Previous studies have shown that heavy drinking can increase risk to cancers, specifically colorectal, liver, larynx and esophageal cancers.

In order to tease apart how a DCIS diagnosis and its treatment affects death from breast cancer, researchers reporting in in JAMA Oncology reviewed records from 108,196 women, the largest number yet in a study of DCIS.

For Esserman, who is the director of the University of California, San Francisco breast care centre, the findings support the notion that some women with DCIS may not need surgery at all. That means that the cancerous breast cells from their DCIS had escaped at some point and survived in the lungs or bone, later developing into a deadly cancer, Narod explained. “It’s just not an emergency”, Dr. Laura Esserman, lead author of the editorial, said in a telephone interview. If the results are confirmed, and treatments do not lower the risk of death from breast cancer, then would surgery, or surgery and radiation still be worth the side effects and complications of that these interventions carry? For the lower-risk DCIS cases, he argues that it may be better not to rush into any treatment.

“It was a pretty provocative study for a surgeon to say there’s a subgroup of patients we shouldn’t be operating on”, said Mehra Golshan, a surgical oncologist at Brigham and Women’s Hospital.

Other experts told the Times that it was too soon to change treatment strategies, but that this study should be an impetus to look at new treatment approaches.

Rehm goes on to say, “Breast tissue might be more susceptible to alcohol than other organs”.

The study also found death rates as a result of DCIS were twice as high for women under 35 when diagnosed and African- American women.