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DCIS Again

Posted 8/29/2013

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  I do realize that this is one of those topics that either holds great interest or almost no interest to any one woman. However, since DCIS is quite prevalent, I am assuming that at least some readers will be glad to see this additional article. The theme is the same: whether the name of the condition makes a difference in how it is perceived and in the treatment choices woman make. That is, since DCIS (and LCIS) are not " really cancer", is it fair to have the C word be part of their label? Does its inclusion just scare everyone unnecessarily?

  This report from Medscape describes a recent study out of Duke University. Women were given a descriptive sentence of a diagnosis and then asked about treatment choice. When the word "cancer" was included, 53% opted for non-surgical intervention. When "cancer" was part of the sentence, 66% chose surgery. This is a big difference and supports the belief that what it is called does indeed impact our reactions and decisions. Stepping back, we can all agree that is nonsensicle, but there it is.

  Here is the beginning and a link to read more:

DCIS Is Not Like a Rose

A rose is a rose is a rose is a law of identity that apparently does not apply to ductal carcinoma in situ (DCIS).
The oft-quoted poetic phrase from American writer Gertrude Stein suggests that a thing is itself no matter what it is called or how it is described.
However, new research indicates that when DCIS is described as a high-risk condition, women make different treatment choices to some extent than when it is described as "noninvasive breast cancer."
When the word "cancer" was not used, 65% of the study participants choose nonsurgical management of the condition.
In short, the study suggests that DCIS is not like a rose because different descriptive terms seem to change the
meaning of the condition for some women.
"These results suggest that many women may prefer nonsurgical options if allowed to weigh each choice and its
attendant risks," write E. Shelley Hwang, MD, from Duke University in Durham, North Carolina, and colleagues in a letter published online today in JAMA Internal Medicine.
The researchers presented 394 healthy women with 3 clinical scenarios that described a diagnosis of DCIS using 1 of 3 terms: abnormal cells, breast lesion, or noninvasive breast cancer.
Each woman reviewed all 3 scenarios and the accompanying set of treatment options (surgery, medication, or active surveillance) and outcomes (chance of developing invasive breast cancer or dying). The information was identical — except for the terms used to describe DCIS.
When DCIS was described as noninvasive breast cancer, 53% (208 of 394) of participants preferred a nonsurgical option. However, when the DCIS was described as a breast lesion, 66% (258 of 394) preferred a nonsurgical option, and when it was described as abnormal cells, 69% (270 of 394) preferred no surgery.
"We conclude that the terminology used to describe DCIS has a significant and important impact on patients' perceptions of treatment alternatives," the researchers write. "Healthcare providers who use 'cancer' to describe DCIS must be particularly assiduous in ensuring that patients understand the important distinctions between DCIS and invasive cancer."

http://www.medscape.com/viewarticle/810029_print

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