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Changing Names of DCIS and LCIS

Posted 5/11/2013

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  DCIS (ductal carcinoma in situ) and LCIS (lobular carcinoma in situ) cause a lot of misery and confusion. The "misery" part is obvious, but the confusion part often makes the misery worse. Numerous studies have suggested that women who are diagnosed with one of these conditions experience the same anxiety and sadness as those who are diagnosed with an invasive cancer. Indeed, not too long ago, both DCIS and LCIS were routinely treated with mastectomy. Only within the past 20 years or so has wide excision and radiation become a standard of care. When mastectomy was the surgery dictated, it was really confusing for women to try to understand why they, with a "cancer" (and most would say these are not cancer) that could not spread, were given only the option of mastectomy while women with invasive breast cancers could often be treated with a wide excision or lumpectomy.

  Clearly if a woman carries a gene mutation (BRCA1 or BRCA2), the consideration of mastectomy or bilateral mastectomies is relevant. If she does not have a mutation, most surgeons are reluctant to perform such large surgeries although they will do so if the woman insists. The expressed concern is that women very often misunderstand and over estimate their risk of future trouble. This is an article from The Breast that recommends a name change. Apparently the recommended replacement would align breast cancer with others and might well make it more clear for women as they make decisions re appropriate treatment.

  Here is the abstract and a link to read more:

 

DCIS and LCIS are confusing and outdated terms. They should be abandoned

in favor of ductal intraepithelial neoplasia (DIN) and lobular intraepithelial

neoplasia (LIN)

Viviana Galimberti a,*, Simonetta Monti b, Mauro Giuseppe Mastropasqua c

a b s t r a c t
The terms ductal and lobular intraepithelial neoplasia (DIN and LIN) were introduced by Tavossoli 15
years ago, who proposed they should replace, respectively, ductal and lobular carcinoma in situ (DCIS and
LCIS). This proposal has been slowly gaining ground. We argue that DCIS and LCIS should now be
de!nitively abandoned. Bringing together ‘in situ’ and other entities into the simpler and more logical
DIN/LIN frameworkeas has been done with intraepithelial neoplasias of cervix, vagina, vulva, prostate,
and pancreasewould eliminate the arti!cial and illogical distinctions between ‘not cancers’ (e.g. "at
epithelial atypia, atypical ductal hyperplasiaenow classi!ed as low grade DIN) and ‘cancers’ (e.g. DCIS
enow considered mediumehigh grade DIN). Elimination of the term ‘carcinoma’ from entities that
cannot metastasize will reduce confusion among health professionals and patients, and contribute to
reducing the risk of overtreatment, as well as reducing adverse psychological reactions in patients. http://www.thebreastonline.com/article/S0960-9776(13)00091-X/fulltext

 

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