Kefah Mokbel, Professor of Medicine at Cardiff University School of Medicine, shared on LinkedIn:
“Does the conventional “precursor” model fully explain DCIS?
I’m persuaded by the argument that DCIS may be better understood within a spectrum of breast cancer biology, with generally low – but variable – lethal potential.
A large observational study of 108,196 women reported an estimated 20-year breast cancer-specific mortality of 3.3% following a DCIS diagnosis.
That finding deserves attention. It also needs context: most women received treatment, risk differed between groups, and the study does not establish what would happen without treatment – or prove that DCIS is invasive disease.
For me, the question is whether our biological models, language and treatment decisions adequately reflect this complexity.
We need better ways to identify who benefits from intervention, who may be suitable for less intensive management, and how to communicate uncertainty without amplifying fear.
I subscribe to questioning the conventional model. The next step is testing alternatives rigorously.
How should this evolving understanding change the way we discuss DCIS with patients?”
Title: Is Ductal Carcinoma In Situ a Precursor or Low-Risk Variant of Invasive Breast Cancer? A Population Perspective
Authors: Ismail Jatoi, Adalberto M. Filho, Gretchen Gierach, Hyuna Sung, Philip S. Rosenberg
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