Breast health centers, affiliated with medical centers around the U.S. are up in arms. Breast imaging radiologists are about to lose one third of their clients because a federal advisory panel just said that women, younger than 50, no longer have to appear each year for a screening mammogram.
Oncologists are also going to see a sharp drop in their actual ductal carcinoma in situ (DCIS) business. These small, non cancerous, often calcified portions of a milk duct, only found through x-ray, are the predominant diagnosis among 40 to 50 year old women who have annual screening mammograms.
Considered to be “stage zero cancer” (stage zero means that you don’t have cancer), these irregular cells are still treated as though they are cancerous, with surgeons performing biopsies, lumpectomies, recommending radiation and estrogen-lowering drugs, and suggesting the idea of single or double mastectomies if patients want to avoid further treatment or eliminate any risks of developing invasive cancrs in the future. Foul ball!
At a national conference on DCIS this past September, experts agreed that we know next to nothing about this condition, except how to find it. The National Breast Cancer Coalition is recommending changing the term DCIS to “atypical hyperplasia,” in order to lower the fear factor that now strikes women when told they have a “ductal carcinoma in situ” or “stage zero breast cancer.” It is nice that honesty is about to see the light of day.
Meanwhile, until last week, the U.S. was the only nation in the world that encouraged women during their 40’s, without any high risk of developing breast cancer, to go near a mammography machine. Over the years, Canadian and European medical practitioners have watched us in disbelief, now they can at least lower their eyebrows.
Here is an email I received a few weeks ago from Paula, a 50 year old mother of two, diagnosed with DCIS after having an annual screening mammogram in 2007.
You may not remember me but I was one of those women who were at one of your first meetings who broke down in tears after having just learned we had breast cancer. …. I went on to research my diagnosis and options.
It turns out I had a very low grade slow growing in situ for which I had a lumpextory. I refused radiation and refused to take tamoxifen — much to the chagrin of my doctors. I am recurrence free after 2 years and continually fighting all the recommended MRI’s (toxic dye solutions) and most of those additional mammorgram they keep trying to give me. I am probably one of those over diagnosed and over treated women who are swelling the ranks of “breast cancer” survivors.
Now that women like Paula will be spared annual screening mammograms in their 40’s, those hospital- sponsored “breast health centers” , that have sprouted up around the country, stand to lose hundreds of millions of dollars in annual revenues, with significant layoffs, as a huge chunk of their youngest clients disappear.
May we can seize this moment and this empty office space as a time to turn the tide toward real breast cancer prevention. Maybe breast health centers can begin to staff up and offer real breast cancer prevention programs, instead of merely mammography, biopsy and lumpectory services. But what would a real breast health center program look like?
In my next post we will look at the kinds of program that real breast health centers can offer. These are programs that can work to limit the number of women who develop breast cancer; For a preview, see Know Breast Cancer’s 7 Easy Ways to help stop breast cancer from happening to you at www.knowbreastcancer.net
To read the full report on what we don’t know abou DCIS and what we need to know about DCIS, formally called.. National Institutes of Health State-of-The-Science Conference Statement – Diagnosis and Management of Ductal Carcinoma In Situ (DCIS) September 22-24, 2009 http://consensus.nih.gov/2009/dcisstatement.htm