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Precancerous Breast Lesions Cause Unnecessary Worry
Date:2/12/2008

derate risk of getting an invasive cancer over the next five years, and 53 percent reported intrusive or avoidant thoughts about DCIS. That number declined to 31 percent 18 months after diagnosis, the researchers said.

Among the 487 study participants who were newly diagnosed with DCIS, 34 percent had undergone a mastectomy, 50 percent had radiation therapy, and 43 percent reported taking tamoxifen to reduce their chances of breast cancer. The type of treatment or combination varied by surgeon, hospital volume and geographic region, the study explained.

"Although decision-making about treatment is complex, there is little doubt that women will be limited in their ability to participate in informed decision-making if they harbor gross misperceptions about the health risks they face," the study authors said. Researchers found a "strong relationship between distress and inaccurate risk perceptions," they added.

One of the difficulties of such measures of anxiety about DCIS is that the study did not determine what these patients had learned from their physicians or from other sources -- such as the Internet -- about DCIS, and how accurate that information was, said Michael Stefanek, vice president of behavioral research for the American Cancer Society.

The choice of treatment depends upon the characteristics of the patient and the lesion, added Partridge, who is also an assistant professor of medicine at Harvard Medical School. The dilemma posed by the prospect of under- or over-treating DCIS is complicated by medicine's current inability to distinguish between "good actors and bad actors" -- lesions that don't recur or go on to become invasive breast cancer and those that do, she added.

Another expert agreed with that assessment.

Everyone would be more comfortable if there wasn't such a "big gray zone" between what is normal tissue and what is invasive cancer, said Dr. H. Gilbert Welch, a professor of medic
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