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DCIS treatment plan? Diagnose your risks further…

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For women who have early breast tumors (DCIS) surgically removed, a genetic test may help predict the odds of a recurrence, a new study says

Ductal Carcinoma in situ

Receiving a diagnosis of Ductal Carcinoma In Situ (DCIS) is difficult. It isn’t really a cancer diagnosis but it is pre-cancer so what is the patient to do?

Most women who are diagnosed with DCIS have a lumpectomy- removing the DCIS cells. Undergoing local radiation reduces the risk of further breast cancer by about 15%.

However many newly diagnosed DCIS patients email me saying that they don’t want to undergo any toxic therapies.

I am a cancer survivor and cancer coach. My advice? Consider the gene test linked below to give you a more information of your risk of breast cancer. Also please consider cheap and easy ways to reduce your risk of breast cancer.

To learn more about DCIS and the evidence-based therapies that can help you prevent its spread into invasive breast cancer, please watch the video below:

To download the DCIS Guide, click here.
To learn more about breast cancer, scroll down the page, post a question or comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

DCIS — Ductal Carcinoma In Situ

“DCIS is called “non-invasive” because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on.

When you have had DCIS, you are at higher risk for the cancer coming back or for developing a new breast cancer than a person who has never had breast cancer before. Most recurrences happen within the 5 to 10 years after initial diagnosis. The chances of a recurrence are under 30%.

Women who have breast-conserving surgery (lumpectomy) for DCIS without radiation therapy have about a 25% to 30% chance of having a recurrence at some point in the future. Including radiation therapy in the treatment plan after surgery drops the risk of recurrence to about 15%. Learn what additional steps you can take to lower your risk of a new breast cancer diagnosis or a recurrence in the Lower Your Risk section. If breast cancer does come back after earlier DCIS treatment, the recurrence is non-invasive (DCIS again) about half the time and invasive about half the time. (DCIS itself is NOT invasive.)”

Gene Test May Help Predict Return of Early Breast Tumor, Study Says

“For women who have early breast tumors surgically removed, a new genetic test may help predict the odds of a recurrence, a new study says.

This refers to abnormal cells in the lining of the milk ducts (Ductal Carcinoma In-Situ or DCIS) that may or may not progress to cancer that invades the surrounding breast tissue. Because there is no way of foretelling a progression, surgery is usually performed to remove the abnormality.

In the new study, researchers looked at whether a new test that zeroes in on certain genes can help predict which women will have their ductal carcinoma in situ recur after surgery. The goal is to aid doctors and patients in deciding on further treatment.

Right now, surgery is often followed by radiation and, in some cases, the drug tamoxifen, said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.

“But we’d all like to have a way to identify women who can avoid further treatment, and those who should have it,” said Lichtenfeld, who was not involved in the study.

But he stressed that the ultimate value of the test — known as Oncotype DX — is not yet known, even though it is already on the market.

The researchers found that among those surgery-only patients, the higher the carcinoma score, the greater the risk of a recurrence over the next decade. For each 50-point increase in the score, the odds of a recurrence doubled.”

The hope, Rakovitch said, is that the Oncotype test will help some women avoid “overtreatment,” while others can feel more confident that they need additional treatment after surgery.

Leave a Comment:

2 comments
Sabrina Ayub says 8 years ago

Dear David,

I don’t know if you will reply to me but I was awake and as usual searching for answers.
I was diagnosed with invasive ductal carcinoma and surgery was on 2015-10-21 and had lumpectomy and sentinel node biopsy
I had 2 tumor and one was size 2.2 cm and one 0.8 cm and my lymp node were negative
I was asked to have Chemotherapy & radiation and as was Hormone positive was given to do hormone treatment also
I opted for Oncotype dx and my reading came 25 and my oncologist showed me the result and no data was found if Chemo would be
beneficial for me or not and as I did not see any benefit in chemo as with Tamoxifen my recurrence chance comes down to 16% and oncologist said
if tamoxifen + Chemo it will decrease to 13 to 14%
I even read on the website that it might help some women but no all and as far as TAILORx test result for intermediate risk for recurrence is also not
available yet

Any advise

Thanks

Reply
    David Emerson says 8 years ago

    I am sorry to learn of your breast cancer diagnosis. However I must say that your tumors are relatively small and a finding of negative lymph node involvement is positive.

    When you end your email with “please advice” I understand you to mean that you are wondering about the possible next steps, if any, of therapy to reduce your risk of relapse of your breast cancer.

    First and foremost, the decision to undergo chemotherapy, aromatase inhibitors (tamoxifen) and or local radiation is up to you.

    1) a lumpectomy reduces the risk of breast cancer relapse.

    2) your oncotype dx score of 25 is considered medium risk- please read the study linked below-

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647116/

    3) I don’t understand how estrogen positive you are when you say you are ” Hormone positive”

    4) You did not mention any sort of local radiation therapy-

    Sabrina- based on your email and my research I think I am coming to the same conclusion that you did. You are right on the boarder of whether or not chemotherapy and tamoxifen will reduce
    your risk of relapse.

    I will say that lifestyle therapies will reduce your risk of relapse- these therapies are easy and inexpensive-

    Slash Your Breast Cancer Risk of Relapse Now!
    http://peoplebeatingcancer.org/blogslash-your-breast-cancer-risk-now/

    Partial as Good as Whole-Breast Irradiation — Clear Result
    http://www.medscape.com/viewarticle/852995?nlid=89584_2203&src=wnl_edit_medn_honc&uac=199231HN&spon=7&impID=866222&faf=1

    Is the Oncotype DX assay necessary in strongly estrogen receptor-positive breast cancers?
    http://www.ncbi.nlm.nih.gov/pubmed/22127090

    I am sorry I can’t provide more definitive information for you. Let me know if you have any questions.

    David Emerson

    Reply
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