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Why women with low risk of DCIS may not need surgery

Doctor: 'For many years, we thought DCIS will always turn into an invasive cancer'
Posted at 2:06 PM, Nov 06, 2020
and last updated 2020-11-06 17:33:24-05

RICHMOND, Va. -- When a woman gets a mammogram, doctors may see something that doesn’t look right. She could end up having a lumpectomy or a mastectomy without ever being diagnosed with breast cancer.

It’s called ductal carcinoma in situ or DCIS. It’s a diagnosis of a pre-invasive or pre-cancer of the breast.

“The majority of these will be something called calcification. It’s something you’ll see on mammograms which are basically little white dots,” VCU Massey Cancer Center's Chief of Breast Surgery Dr. Kandace McGuire said.

“For many years, we thought DCIS will always turn into an invasive cancer. Now, we're starting to consider maybe that's not the case,” Dr. McGuire said.

The standard of care for treating DCIS has been doing a lumpectomy or a mastectomy and sometimes radiation.

“It’s potentially over-treating thousands of women who have a very, very low risk of developing an invasive cancer,” Dr. McGuire said.

Many breast cancer doctors such as Dr. McGuire now believe women with low risk of DCIS may not need surgery. Dr. McGuire is leading a trial at Massey called COMET (Comparison of Operative to Monitoring and Endocrine Therapy). Six women are involved at Massey so far. Nationally, the study will enroll 1200 women with low risk DCIS. During the trial, one group will have standard care---surgery and radiation. The second group will be actively monitored with more breast screenings and given medication.

“If we see a change in their breast exam, then we go to surgery. If they don’t, we just keep following things,” Dr. McGuire said.

The goal is to see if many of these women can avoid surgery.

“The opportunity to avoid that for something that may never turn into an invasive cancer that may never to be a threat to your life. It's pretty fantastic,” Dr. McGuire said.

Doctors will follow these women for two years. Doctors are accepting more COMET trial participants. If you’re interested, here’s the contact information: mckelveyms@vcu.edu or call 804-628-6430

Click here for more information about COMET.

Reba Hollingsworth continues Buddy Check 6 reports in honor of Stephanie Rochon
Reba Hollingsworth continues Buddy Check 6 reports in honor of Stephanie Rochon

On the 6th of the month, CBS 6 and VCU Massey Cancer Center remind women to contact their buddy to remind them to conduct a monthly breast self-exam. If it is time, you should also schedule an annual clinical breast exam and mammogram, which are key to early detection.