Dr Oz did a segment called “Breast Cancer Alert: Could Early Diagnosis Be Dangerous?” in which he discussed Ductal Carcinoma In Situ or DCIS. Some of the scariest words a woman can hear is “you have breast cancer” because you start to get images of a lumpectomy, mastectomy, chemotherapy, and radiation treatments. But what if you find out the diagnosis you received was wrong? Doctor Oz said that 260,000 women in America will find out they have breast cancer this year, and 1/5 of them will be Ductal Carcinoma In Situ or DCIS. DCIS can turn into a very dangerous cancer, but DCIS can also be in a form that is relatively benign and won’t cause issues. So should you treat a suspicious spot before it becomes dangerous, even if it may never become dangerous?
Dr Oz said that Ductal Carcinoma In Situ is not when you find a lump in your breast, but it is a tiny cluster of calcification or suspicious cells, maybe only as much as a few grains of rice. Dr Oz asked Dr. Laura Esserman why we should not consider DCIS like cancer when we find out we have it. Dr Esserman said that we really should not use the word cancer for something that is not life threatening and we should call things by what they are. DCIS looks like cancer stuck in the milk ducts, and now with better technology, we are picking up DCIS more than ever. However, not all DCIS should be treated the same. Some forms of Ductal Carcinoma In Situ are high risk and others are lower risk. If you have the diagnosis of DCIS, you have to dig deeper to see if it might be life threatening and to be sure that you will not do more harm than good. All forms of breast cancer used to be treated the same, but now doctors are learning that they can safely do a lot less.
Dr Oz was also joined by Dr Ruth Oratz, who said that DCIS is not so dangerous itself, but it is a marker that something might happen in months or even years. Ductal Carcinoma In Situ is not an emergency, but its must be taken care of in a timely fashion, according to Dr Oratz. She spoke about a recent patient she had where they took out DCIS and right next to it they found the beginnings of an invasive carcinoma.
Dr Oz did a demonstration using a cherry pie to represent a breast. If you do a mammogram, and it comes back showing some calcium deposits, you will usually have a needle biopsy done in the area. However, a needle biopsy often does not come back with conclusive results. This is when a surgeon is often called on to take out some breast tissue with a scalpel. Only at this point can you really see what is going on inside. One of the cherry pies had no cherries inside and was considered like a “healthy breast” but the other pie had cherries in it to represent potentially deadly cancer cells. So is it worth the damage to your breasts to look for something that might not even be cancer nor cause cancer? 50-80% of the time a biopsy comes back with an indication of no cancer, so my takeaway is that if you get diagnosed with Ductal Carcinoma In Situ, then do not think it is a death sentence because in most cases it sounds pretty benign. Here are some guidelines for determining whether you have a benign calcification. First, a good breast radiologist should be able to make the call, but get a second opinion if in doubt. If your doctor thinks it is safe, maybe come back for more images to be done in 6 months. You can also look into other breast imaging options like an ultrasound or MRI.
Breast Cancer Detection
Dr Oz suggests doing the following to help prevent breast cancer:
1. Self exams & get to know your breasts
2. Get a mammogram every year if you are age 40 and have risk factors, or get a mammogram every other year if you are over the age of 50.
What To Do When Diagnosed With Ductal Carcinoma In Situ (DCIS):
1. Ask to see the pathology report. What size was the Ductal Carcinoma In Situ and what are the margins (the amount of normal tissue around the cells).
2. Ask if the images were reviewed by any other hospital or individual.
3. Ask who analyzed the slide. You can always send the slide to a breast cancer specialist if you notice the person who analyzed your images has minimal experience in breast cancer.
4. Get a second opinion.
One of Dr Oz’s guests mentioned that a Dr Wong is doing a study right now on alternatives to surgery for women with low risk Ductal Carcinoma In Situ, which include diet and exercise. I’m currently trying to find more information about this study and alternative treatment for Ductal Carcinoma In Situ, so if anyone knows more about this study, please leave a comment below!