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Ductal carcinoma in situ, abbreviated as DCIS, is held to be the earliest indicator of breast cancer. Every year, 50,000 woman are diagnosed with DCIS in the United States. Many of these women opt for surgery to remove the mass of irregular cells, which appears near the milk ducts on the breast. Some even go so far as to have a double mastectomy performed, ensuring that risk of breast cancer is completely eliminated.
However, it is estimated that only 30 percent of women diagnosed with DCIS would actually develop breast cancer if left untreated. The other 70 percent are misdiagnosed with cancer, suffer overly-preventative medicine or are the victim of different doctor error.
Among the doctors informing women that they have DCIS, there is no standard for diagnosis.
As Stephanie Saul reports in the New York Times, this discrepancy has led to wide range of accuracy among the different hospitals where women are diagnosed. One woman, Monica Long, had a quarter of her right breast removed and endured months of chemotherapy, only to be told later that the doctor who diagnosed her DCIS was most likely incorrect in his assessment.
DCIS is signified by the multiplication of abnormal cells, resulting in a mass within the breast. Some masses are large, while others are barely visible. These cell clusters are not cancerous, but some have the potential to develop into cancer, which means that surgery and treatment around DCIS are entirely preventative in nature.
This also means that interpretation of mammogram results is key in diagnosing DCIS and that, without standards for doing so, most doctors have to operate on experience and the facts at hand. If either or both are lacking, cancer misdiagnosis can occur.
In 2006, the breast cancer organization Susan G. Komen for the Cure released a study estimating that some 90,000 cases of DCIS were the result of misdiagnosis or other pathologist error.
Breast cancer is a sensitive subject, and a frightening proposition for women everywhere. In many ways, it’s an area where the constant specter of the disease might cause doctors to overprescribe and some patients to commit to surgery before weighing the options.
For women diagnosed with DCIS, the best next step to take is a cautious one.