Examining your approach to the earliest stage of breast cancer - DCIS

Fighting breast cancer is an individual journey. Research clarifies some questions, but a study this summer raised new ones on handling the earliest stage of breast cancer.

Diane Waeltz says she's a poster child for the importance of mammograms.

"When I was 46, I went for my mammogram and said, 'See you next year,' and 24 hours later, my family doctor called me to say it was abnormal, I needed to go back."

Follow up tests showed she had DCIS - ductal carcinoma in situ, which means abnormal cells in the milk ducts. It's also called Stage 0 breast cancer, or even pre-cancer.

Dr. Mark Sundermeyer from Abington Memorial Hospital explains, "The cancer that is not invading the tissue. It's kind of pushing against the margin, but not yet reaching the invasive stage."

Dr. Sundermeyer says standard treatment has been a lumpectomy to remove the abnormal cells, followed up with radiation. However, a study in the Journal of the American Medical Association this summer challenged that, saying radiation, and maybe even surgery, might not be necessary.

Dr. Sundermeyer tells us, "Radiation is good at reducing the risk of it coming back in the breast. But that doesn't affect whether a patient lives longer."

Dr. Sundermeyer believes treatment decisions involve more factors. Such as if genetic tests suggests the cells could become invasive later, or if the patient's race or age are a factor. African-American women and those under 35 were more likely to die from invasive cancer.

Plus, is she comfortable with "watchful waiting" versus more aggressive treatment?

Diane says, "I can't imagine sitting and waiting on that, to see if it developed into a tumor."

Dr. Sundermeyer says, "We still don't know for sure which patient we can be less aggressive with."

Diane opted for surgery and radiation, but not until she got a second opinion and information from reliable medical resources.

"Making an educated decision gave me confidence I did the right thing," she said.

Dr. Sundermeyer says the question won't be settled until there are more studies, following thousands of women with low-risk cells who don't get radiation.

For now, anyone in this situation should talk to their oncologist about their options and also get a second opinion.