Interview
with Neil Love, MD from Breast Cancer Update for Surgeons,
Program 1 2000
Play
Audio Below:
We
have sort of this cultural approach that DCIS is cancer and we’ve
got to do something severe about it. And it brings us to the paradox
— as it does with high-risk people — that the prophylaxis,
surgically, is a bigger operation than the actual treatment for
cancer has become. In the case of DCIS, there’s a certain logical
merit to this because while we have statistics that say that invasive
cancer is equally curable or equally not curable, depending on mastectomy
or conservative surgery, it remains that DCIS can be essentially
100% cured with total mastectomy. Whereas, conserving surgery leaves
open the chance that there will be recurrence, that that recurrence
will be invasive cancer, and that some people will die of that.
I think it’s important to understand that even total mastectomy
doesn’t cure 100% of the people. If you need proof for that
just look at the entity we call occult breast cancer, where people
show up with lymph node metastasis and we don’t see a primary,
and they even show up with distant metastasis and we don’t
see a primary. So we understand why people with DCIS may die of
their disease even though the mastectomy should have cured them.
The question is if you do other treatments like breast conserving
surgery and radiation, what is the risk of dying? And the answer
that we seem to have is, "It’s no greater."
