Study raises doubts about early-stage Breast Cancer treatments

Aggressive interventions to treat the earliest, “stage 0” breast cancers have no effect on whether a woman is still alive a decade later, according to a massive new study that tracked the trajectories of more than 100,000 women. The study found that the risk of dying from these early cancer lesions, called ductal carcinoma in situ, is very low, only around 3.3 percent of women in the study died of breast cancer over two decades. It is the latest addition to a growing body of evidence that suggests the ability to detect these lesions through mammograms may be leading to over treatment of breast cancer. Women faced with these noninvasive cancers, often referred to as stage 0, face a frightening array of options: Most undergo a lumpectomy to remove the abnormal cells, but they may also receive radiation treatment. Some may even take the extreme measure of removing one or both breasts completely. The study suggests that adding radiation to a lumpectomy may diminish the likelihood the cancer recurs but not whether women live or die.
Right now, two studies in Europe are beginning to examine what happens when women with the same diagnosis are given different treatments: for example, if the patients are simply observed vs. given the current standard treatment.
“I think the time has come to do trials where we back away from, for example, radiation in many women and we in a meaningful way look at the question as to whether radiation adds anything to surgery,” said Eric Winer, director of the breast cancer program at Dana-Farber Cancer Institute.
The problem with that may be convincing women to accept less care.
“There are going to be a lot of women who are simply not very comfortable with that approach.”