Is It Safe To Avoid Certain Surgeries During Early Breast Cancer Treatment ?

WASHINGTON (dpa-AFX) - According to the American Cancer Society, every year over 50,000 women suffer from ductal carcinoma in situ or DCIS, often known as 'zero-stage breast cancer' or 'precancer'.

DCIS occurs when the cells lining the milk duct turn cancerous, while the nearby cells remain healthy. The Breast Cancer Research Foundation reported a 98 percent survival rate over 10 years in women with DCIS.

Generally, women undergo surgeries, radiation, hormone therapy and sometimes chemotherapy to treat the cancer. However, the recent study, published in JAMA, suggested that active monitoring could be a safe alternative to standard care.

'These early results are provocative and potentially exciting for patients,' said Dr. E. Shelley Hwang, co-principal investigator and vice-chair of research at Duke Cancer Institute's surgery department.

'If these results hold up over time, most patients who have this type of low-risk disease will have the option of avoiding invasive treatments.'

'That would be a complete change in how we care for these patients and think about this disease.'

For the study, the researchers monitored over 950 women aged 40 and above who received a confirmed diagnosis of DCIS after a biopsy. They were randomly divided into two groups - first one received the standard care, while the second one underwent active monitoring.

The participants in the second group had routine mammograms for every six months for the affected breast and every 12 months for the unaffected one.

At the end of two years, the rate of invasive cancer was 5.9 percent in the surgery group, whereas it was 4.2 percent in the non-surgery group.

'Active monitoring - from both a disease and quality of life standpoint - appears to be safe and well tolerated in women with low-risk DCIS,' said Dr. Ann Partridge, interim chair of medical oncology at the Dana-Farber Cancer Institute and another lead author on the study. 'It expands options for women if we continue to show safety.'

However, the researchers plan to continue monitoring the participants to determine the long0-term safety of active monitoring as some women in this group might develop more advanced cancers over time.

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