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Women Diagnosed With "New" Breast Cancer Could Potentially Benefit From a "Watch and Wait" Approach

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Doctors recently discovered a “new” type of breast cancer: Ductal Carcinoma in Situ, or a specific type of cancer whereby malignant cells grow in the milk ducts of the breast. However, doctors are divided over whether to diagnose this type of cancer as a “very early breast cancer” or a precancerous state.

DCIS is rarely life-threatening, although some women have gone through draining procedures and treatments such as radiation or partial lumpectomies. Usually, these aggressive treatments are reserved to treat serious life-threatening forms of cancer. However, doctors diagnosed Barbara Laufer with DCIS and she subsequently underwent two lumpectomies to her left breast, as well as daily radiation treatment for seven weeks. Now she is on a hormonal treatment called Tamoxifen to keep the cancer from returning and cannot have children for five years because of the risk of potential birth defects from the medication.

Currently, more than 60,000 women are diagnosed each year with DCIS. Doctors are afraid to spare women from the rigors of regular cancer therapies because so little is known about this new form of cancer. However, for women like Laufer, lives are put on hold when it isn’t even clear whether or not such aggressive treatments are necessary. On the other hand, some women are too afraid to try the “watch and wait” approach—fearful that their cancer will be a death sentence. A recent Breast Cancer Symposium in San Francisco may offer guidance for doctors who aren’t sure what to tell their patients with DCIS. Specifically, from a study of 8,203 women, researchers found that patients between 45-50 had half the risk of relapse after undergoing aggressive cancer treatments when compared with their younger (44 and under) counterparts. This may offer hope to younger women like Laufer who don’t want to undergo treatments that won’t necessarily keep them cancer-free in the long run. Laufer is now 37 and will have to wait until she is 44 ½ to have a child because of the Tamoxifen medication she is required to take. If she could wait for a treatment until later on in her life or not have to undergo treatment at all, she could still potentially bear children of her own. As Susan Reid, an OBGYN at Seattle’s Fred Hutchinson Cancer Research Center recently stated: "[w]e’re asking women to make decisions that are crucial to their lives, without a lot of hard evidence…we’re giving them a lot of uncertainty." Perhaps a “watch and wait” approach isn’t such a bad idea when women’s lives are drastically changed without the promise of remaining cancer-free afterall.