Experts Recommend New Name, More Research On Nonmalignant Breast Tumor

Main Category: Women's Health / Gynecology
Also Included In: Breast Cancer
Article Date: 28 Sep 2009 - 1:00 PDT

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On Thursday, a panel of medical experts convened by NIH recommended that the word "carcinoma" be removed from the name of a nonmalignant breast tumor called ductal carcinoma in situ because the current terminology can mislead some women into believing they are likely to develop breast cancer, Reuters reports. DCIS is a condition in which abnormal cells have grown in the milk duct but not spread to breast tissue. The panel said more research is needed to determine the likelihood that a woman's DCIS will progress into actual invasive breast cancer.

Since the start of widespread mammography in the late 1980s, DCIS diagnosis rates have increased sevenfold. By 2020, approximately one million U.S. women are expected to be living with the condition (Steenhuysen, Reuters, 9/24). More than 50,000 women are diagnosed with DCIS annually (Neergaard, AP/Baltimore Sun, 9/24).

Because DCIS is believed to be a risk factor for developing invasive breast cancer, the abnormal cells are removed, and only about 2% of DCIS patients die of breast cancer within 10 years. However, doctors have no way of knowing which women were at risk of developing invasive cancer and which would have remained healthy without treatment. In addition, there are vast differences in how the condition is treated, ranging from simple surgeries to chemotherapy or even protective removal of the opposite, healthy breast, the AP/Baltimore Sun reports (AP/Baltimore Sun, 9/24).

The panel concluded that a significant amount of new research is needed to determine which women can safely forgo intensive treatment (AP/Baltimore Sun, 9/24). "Despite having had a century of knowledge of the disease, we do not understand the natural history of DCIS, and probably never will," according to panel Chair Carmen Allegra, an oncologist at the University of Florida (Reuters, 9/24).

The panel said that changing the name of the condition will help doctors better convey that while growth should not be ignored, there is no need for panic. While the experts did not offer an alternative name, Allegra said that the current inclusion of "carcinoma" in the name "carries with it such a disproportionate level of anxiety relative to the relatively indolent nature of the disease" (AP/Baltimore Sun, 9/24). Panel member Arnold Schwartz, a surgical pathologist at the George Washington University Hospital, disagreed with the panel's recommendation to change the name. He said that many other cancers and precursor cancers include the name carcinoma in situ -- including those of the skin, head and neck, esophagus and bladder -- "without any emotional impact" (Reuters, 9/24).

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