"Breast Cancer Bombshell" - Reality or Media Hype?

Patient Expert

A well-known national media outlet headlined its morning television news Friday with the words "Breast Cancer Bombshell" splashed across the screen. And yet the ensuing story was scarcely a "bombshell" to those who follow breast cancer research. For real news, you need to read beyond the headlines.

Another day, another breast cancer research study released. Yawn.

Well, it's not quite THAT bad. But due to increased awareness around breast cancer, which in turn has led to more funding for research, there's all kinds of breast cancer "news" being reported these days.

Some of it's interesting: a breast cancer vaccine is going through clinical trials and may just pan out.

Some of it's actionable: exercise reduces breast cancer risk.

Some of it's head-scratching: working a night shift increases breast cancer risk. Wow, really?

And some of it's just not really news… following as it does on the heels of years of studies producing similar results.

New study results mirror previous research

That was the case late last week, when print, online, and broadcast media all jumped on a study in the journal JAMA Oncology. The media take: women with a diagnosis of stage 0 breast cancer (DCIS, ductal carcinoma in situ), may be undergoing too much treatment.

Briefly, researchers followed over 100,00 women, all with a DCIS diagnosis, for over a decade. And here's what they found:

•Following lumpectomy but no other treatment, the risk of dying of breast cancer within 20 years for most women with DCIS was the same as that of the general population: 3.3%.

•An exception is black women and women under age 35 at time of diagnosis, whose risk of dying from breast cancer is higher.

Radiation decreases the risk of recurrence within 10 years of diagnosis, but doesn't affect risk of death over that same time period.

Mastectomy of one or both breasts doesn't increase chances of survival over 20 years.

In other words, unless you're under age 35 at time of diagnosis, or a black woman, neither radiation nor mastectomy will improve your chance of survival – which, with a DCIS diagnosis, is already sky-high.

Due to improved screening technology, as well as raised awareness of breast cancer, more and more women are being diagnosed with stage 0 breast cancer: about 20% of all new breast cancer diagnoses are for DCIS.

And women with this diagnosis are typically advised to have surgery to remove the pre-cancerous lesion (lumpectomy); followed by radiation to "clean up" any lingering abnormal cells; and then 5 years or more of hormone therapy, if the lesion is found to respond to estrogen/progesterone.

Some women, feeling uneasy with removing just the small area of the breast with abnormal cells, opt for a mastectomy: full breast removal. And some, experiencing even more fear, decide to have both their breasts removed.

More treatment doesn't equal improved survival.

Yet these aggressive treatments evidently don't lower the woman's risk of dying from breast cancer. All they do is remove her breasts – with all of the danger, pain, and long-term side effects that action entails.

Again, this isn't new news. Researchers have been seeing similar results for years, and there's been a growing call to stop overtreatment of early breast cancers or pre-cancers.

But the problem is, if you're diagnosed with DCIS, doctors can't tell you if it will ever develop into something more serious. Currently, there's no way to classify DCIS into "benign," "watch and wait," or "potentially fatal." Thus, many women choose drastic measures to treat what might be a perfectly harmless condition.

The real news will be when there's finally a test to determine exactly how much treatment is needed to provide the greatest benefit with least risk for women diagnosed with DCIS.

Now THAT will be a bombshell.

Sources

Johnson, Carolyn, and Ariana Eunjung Cha. "Study Raises Doubts about Early-stage Breast Cancer Treatments." Washington Post. August 20, 2015. Accessed August 21, 2015.

Narod, Steven. "Breast Cancer Mortality After Ductal Carcinoma In Situ." JAMA Network. August 20, 2015. Accessed August 21, 2015. http://oncology.jamanetwork.com/article.aspx?articleid=2427491.

See more helpful articles:

[Do You Really Need Radiation? Maybe Not.](file://localhost/site/healthcentral.com:breast-cancer:c:78%20unnecessary)

Lumpectomy vs. Mastectomy: Surprising New Findings

Diagnosed With DCIS? Here's What You Need to Know Right Now

Redefining Breast Cancer: NCI Task Force Seeks to Reduce Overtreatment

First, Don't Panic: Do You REALLY Need a Mastectomy?

Breast cancer survivor and award-winning author PJ Hamel, a long-time contributor to the HealthCentral community, counsels women with breast cancer through the volunteer program at her local hospital. She founded and manages a large and active online survivor support network.