Patients overestimate chances of cancer returning
By Stephen Smith, Globe staff
Women treated for a highly survivable form of breast cancer tend to overestimate the likelihood that the cancer will return or that they will die from a breast malignancy, researchers from the Dana-Farber Cancer Institute report today.
A survey of nearly 500 women who had been treated for ductal carcinoma in-situ found that more than half believed they had at least a "moderate likelihood" of the cancer returning within five years, and two-thirds thought it was moderately likely that it would recur at some point during their lives. More than one in four of the women believed that it was at least moderately likely that the condition would spread to other parts of their bodies.
Those fears vastly overestimate the actual danger posed by ductal carcinoma in-situ, a condition marked by the uncontrolled growth of cells within the milk ducts of a breast. The disease is typically treated successfully with either complete or partial breast removal, often followed up with radiation.
The risk of ductal carcinoma in-situ spreading outside the breast -- and thus becoming life-threatening -- is less than 1 percent. The chance of the growth returning to the breast is 1 percent after a mastectomy and less than 10 percent after breast-conserving surgery, the scientists report in the online edition of the Journal of the National Cancer Institute.
The lead author of the study, Dr. Ann Partridge of Dana-Farber, said in an interview that the researchers decided to conduct the survey because "we have the perception that women with ductal carcinoma in-situ are more anxious than we would like them to be and feeling very, very fearful that their cancer is going to come back."
The reasons for that anxiety are complex, Partridge said. In part, she said, it's a reflection of fears overwhelming facts, with patients' understandable concern about a cancer diagnosis muting a more nuanced message about actual risk.
"And on the flip side," Partridge said, "we as healthcare providers could do a better job of conveying the risk" and recognizing when patients are failing to understand it
What they don't mention is that people under 40 have a much lower rate of going into remission. All the money on research gets spent on pediatrics and older folks. The remission rate for those between 18-40 is only 50%!! For anyone that is looking for support in this age group, check out imtooyoungforthis.org
Did Tom read the same article I did?!? Ductal carcinoma in situ, or DCIS, "is typically treated successfully with either complete or partial breast removal, often followed up with radiation". Since it's entirely within the milk ducts (unless found very late), removal of the breast pretty much does the trick. There is no remission. It's removed. Doesn't matter your age, if the milk ducts go, the DCIS is gone. Not in remission. I've been through this. "Remission" was never said by anyone on my medical teams. My treatment was entirely mechanical, albeit traumatic. You cannot beleive the relief I felt coming out of my surgery, knowing that the cancer was away from me.
was diagnosed with dcis in 1993. I did not have a sense of doom until I applied for life insurance. I don't know what statistics they work from, but, the increase in life insurance premium is greater than the 1% increased risk of returning dcis.
Yeah, I was diagnosed with DCIS by Duke University Hospital no less, and after my "simple" surgery found out I actually had stage 3 Lobular cancer with BRCA2, Her2, etc... my sense of calm and trust in the medical community went out the window!
I've just been diagnosed with a recurance of DCIS. Am I correct , given that DCIS returned after lumpectomy and radiation over 10 years ago, the chance of it now spreading OUTSIDE the breast is less than 1% ? Having had radiation, my only recourse now would be masectomy. Looks like the odds are 99% in my favor by doing nothing ?
Jane Doe,
You should consult with a doctor about the applicability of the 1 percent figure to your situation.
I WAS DIAGNOSED WITH DCIS 5 YEARS AGO AND IT HASN'T CAME BACK. I GO NEXT MONTH FOR MY MAMMOGRAM SO THIS ARTICLE MADE ME FEEL MUCH MORE CONFIDENT THAT IT WON'T COME BACK. I PRAY FOR ALL OF THOSE WHO HAVE OR HAVE HAD CANCER THE WORD ITSELF IS TERRIFYING.
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