Breast cancer screening: in the wake of the report of the Independent Review, why is Ductal Carcinoma in Situ (DCIS) being described as ‘malignant tumour’ by those who should know better? DCIS is not a tumour. It is a collection of abnormal cells confined to the breast duct.
DCIS officially becomes ‘cancer’ ONLY IF abnormal cells break through the basal membrane and become invasive cells. This may never happen! In which case women who do not attend screening would never even be aware of them – but those who do would most likely have lost a breast via mastectomy – because if the smallest abnormalities are found, they tend to be treated.
By continually referring to DCIS as cancer or malignant tumour(s), those in authority continue to spread fear as an inducement to attend for breast screening. Women should be told the truth – research has shown they have much more chance of losing their breast if they do attend.
1 Any DCIS (calcifications) might well never become a problem.
2 Fast growing cancers are likely to appear between screenings. Fast growing cancers are less likely to respond to treatments.
3 Slow growing cancer that are likely to be found at screening would just as easily/successfully have been treated if found later when producing symptoms, with as much impact on mortality.
4 Modern understanding of breast cancer is that finding it ‘early’ or ‘small’ can make no difference to date of death as it could have spread microscopically even when only detectable by mammography.
Elissa M. Ozanne et al. Characterizing the Impact of 25 years of DCIS Treatment. Breast Cancer Res Treat (2011) 129: 165-173
Gyda Lolk Ottesen et al Carcinoma in Situ of the female breast: 10 year follow-up results of a prospective nationwide study. Breast Cancer Research and Treatment 62: 197-210, 2000.