Skip the Scalpel? Breast Cancer’s New Alternative
Every year, around 50,000 women in the United States are diagnosed with ductal carcinoma in situ (DCIS). This condition occurs when the cells lining the milk ducts become cancerous, but the surrounding breast tissue remains unaffected. Traditionally, many women choose surgery to treat DCIS, but new research raises the possibility of an alternative approach.
The Case for Active Monitoring in DCIS
A recent study, published in the Journal of the American Medical Association, suggests that active monitoring could be a safe alternative to surgery for some women with low-risk DCIS. This approach involves regular mammograms and check-ups to monitor the condition instead of immediately resorting to surgery.
Dr. Virginia Kaklamani from the University of Texas Health Science Center noted that this research confirms a long-standing belief: many women with DCIS may be overtreated. However, not all experts are convinced. Dr. Monica Morrow of Memorial Sloan Kettering Cancer Center cautioned that more time is needed to understand the long-term outcomes fully.
Study Findings: Monitoring vs. Surgery
The study followed over 950 women in the U.S. who were randomly assigned to either surgery or active monitoring. All participants had low-risk DCIS, a type of cancer that responds well to hormone-blocking drugs.
After two years, the rates of invasive cancer were similar between the two groups—6% for the surgery group and 4% for the monitoring group. Some participants in the monitoring group later opted for surgery if changes were detected during their mammograms.
Although the results are promising, researchers plan to track these patients for a decade to confirm the long-term safety of active monitoring.
Real-Life Impact: One Patient’s Perspective
Tina Clark, 63, from Maine, joined the study in 2019 after being diagnosed with DCIS. She was placed in the monitoring group and avoided surgery during a difficult time in her life. Regular mammograms have shown no advancement in her DCIS, though she underwent surgery for an unrelated cancer in her other breast in 2023.
Reflecting on her experience, she emphasized the importance of understanding treatment options, saying, “If you’re diagnosed with low-risk DCIS, you have time to learn about your disease and make informed decisions.”
Rethinking Lymph Node Removal
In another study, researchers explored whether removing lymph nodes is always necessary for women with early-stage breast cancer. Lymph node removal, a common practice during surgery, can help determine if cancer has spread. However, the procedure can cause long-term side effects like arm swelling and chronic pain.
A study conducted in Germany followed 4,858 women with early breast cancer. Half underwent lymph node removal, while the other half did not. After five years, survival rates were nearly identical—92% in both groups.
Dr. Morrow explained that while lymph node removal does not improve survival rates, it may still be necessary for some women to decide on post-surgery treatments.
A Shift Toward Personalized Care
Both studies represent a shift in breast cancer treatment, emphasizing less invasive options where appropriate. For patients with low-risk DCIS or early-stage breast cancer, these findings provide hope for tailored approaches that minimize the physical and emotional burden of treatment.
Ultimately, these decisions should be made in consultation with healthcare providers, considering individual risk factors and preferences. As more data becomes available, these findings may help reshape the standard of care for many women.
Source: Inputs from various media Sources
I’m a pharmacist with a strong background in health sciences. I hold a BSc from Delhi University and a pharmacy degree from PDM University. I write articles and daily health news while interviewing doctors to bring you the latest insights. In my free time, you’ll find me at the gym or lost in a sci-fi novel.
