{"id":199222,"date":"2024-12-20T15:03:19","date_gmt":"2024-12-20T15:03:19","guid":{"rendered":"https:\/\/news.talkwithrattan.com\/index.php\/2024\/12\/20\/stage-0-breast-cancer-patients-may-not-need-to-rush-to-surgery\/"},"modified":"2024-12-20T15:03:19","modified_gmt":"2024-12-20T15:03:19","slug":"stage-0-breast-cancer-patients-may-not-need-to-rush-to-surgery","status":"publish","type":"post","link":"https:\/\/news.talkwithrattan.com\/index.php\/2024\/12\/20\/stage-0-breast-cancer-patients-may-not-need-to-rush-to-surgery\/","title":{"rendered":"Stage 0 breast cancer patients may not need to rush to surgery"},"content":{"rendered":"<div style=\"text-align:center\"><img decoding=\"async\" src=\"https:\/\/i0.wp.com\/www.sciencenews.org\/wp-content\/uploads\/2024\/12\/121324_ts_breast-cancer_inline.jpg?fit=680%2C713&amp;ssl=1\" class=\"attachment-post-thumbnail size-post-thumbnail wp-post-image\" alt=\"Stage 0 breast cancer patients may not need to rush to surgery\" title=\"Stage 0 breast cancer patients may not need to rush to surgery\" \/><\/div> \r\n<br><div data-component=\"video-embed\">\n\t\t\t\t\n\n\n\n\n<p>Watch and wait may be an alternative to surgery for some women with a very early form of breast cancer.<\/p>\n\n\n\n<p>A new study of 957 women evaluated whether it was safe to do active monitoring of a low-risk form of ductal carcinoma in situ, or DCIS \u2014 a noninvasive cancer, often called <a href=\"https:\/\/www.sciencenews.org\/article\/stage-zero-breast-cancer\">Stage 0 breast cancer<\/a>, that hasn\u2019t spread beyond the milk ducts \u2014 as an alternative to surgery (<em>SN: 8\/30\/24<\/em>).<\/p>\n\n\n\n<p>After two years of follow-up, women who were assigned to get active monitoring had <a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2828218\" target=\"_blank\" rel=\"noopener\">no more invasive breast cancer<\/a> than women assigned to get surgery, researchers report December 12 in <em>JAMA<\/em>. In fact, in the surgery group, there was an 8.7 percent cumulative rate of invasive cancer, compared with a 3.1 percent rate in the monitoring group.<\/p>\n\n\n<aside class=\"sn-conversion rich-text rich-text--with-sidebar\">\n<style><![CDATA[\n.email-conversion {\n  border: 1px solid #ffcccb;\n  color: white;\n  margin-top: 50px;\n  background-image: url(\"\/wp-content\/themes\/sciencenews\/client\/src\/images\/cta-module@2x.jpg\");\n  padding: 20px;\n  clear: both;\n}\n\n]]><\/style>\n\n\n\n<div class=\"rich-text embedded-conversion-content is-layout-flow wp-block-group-is-layout-flow\"><div class=\"wp-block-group__inner-container\">\n<style><![CDATA[\n#dynamic-wrapper {\n  border: 1px solid #ffcccb;\n  background-image: url(\"https:\/\/www.sciencenews.org\/wp-content\/uploads\/2024\/11\/cta_background_aurora.jpg\");\n  background-size: cover;\n  background-position: center center;\n  padding: 20px;\n  clear: both;\n}\n\n#dynamic-conversion {\n  padding: 20px;\n  background:rgba(0,0,0, 0.5);\n  color: white;\n}\n\n#dynamic-conversion h2 {\n  color: white;\n}\n\np.has-text-align-center a {\n  color: white !important;\n  text-decoration: none;\n  font-weight: bold;\n}\n\n]]><\/style>\n\n\n\n<div id=\"dynamic-wrapper\" class=\"wp-block-group\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<div id=\"dynamic-conversion\" class=\"wp-block-group\"><div class=\"wp-block-group__inner-container is-layout-flow wp-block-group-is-layout-flow\">\n\n\n\n\n<h2 class=\"wp-block-heading has-text-align-center\"><strong>Have feedback for Science News?<\/strong><\/h2>\n\n\n\n\n\n\n\n<p class=\"has-text-align-center\">Help us improve by telling us about your experience<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n<\/div><\/div>\n\n\n\n\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n<\/aside>\n\n\n<p>Of cancers found in the monitoring group compared with those discovered during surgery, \u201cthose cancers weren\u2019t any bigger, they weren\u2019t any more likely to have spread, says Shelley Hwang, a breast cancer surgeon at Duke University School of Medicine.<\/p>\n\n\n\n<p>Active monitoring included mammograms every six months and hormone therapy for most participants. Of the 484 women in the monitoring group, 82 ended up having a lump or entire breast removed. The 473 participants assigned to the surgery group often also got radiation and hormone therapy. A handful of volunteers in each group got chemotherapy.<\/p>\n\n\n\n<p>The results suggest that a watch-and-wait approach is safe in the short term and may even be superior to surgery for low-risk DCIS because it helps women avoid treatments for a precancerous condition that may never become life-threatening, Hwang and colleagues say. \u00a0<\/p>\n\n\n\n<p>But \u201ctwo years of follow-up is way, way, way too short to draw that conclusion,\u201d says Monica Morrow, a surgical oncologist and chief of breast cancer surgery at Memorial Sloan Kettering Cancer Center in New York City, who coauthored an <a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2828219\" target=\"_blank\" rel=\"noopener\">editorial<\/a> about the study that also appeared December 12 in <em>JAMA<\/em>. She points out that while women in the monitoring group who got delayed surgery didn\u2019t have big statistical differences in the size of their tumors from the surgery group, the monitoring group had more cancers that were bigger than one centimeter than in the group that got surgery right away.<\/p>\n\n\n\n<p>\u201cAs cancers get bigger, the risk of spread to the women\u2019s [lymph] nodes goes up. The amount of drug therapy we give to treat them increases,\u201d Morrow says. \u201cSo, if by delaying surgery, you end up getting more aggressive treatment than you would have gotten if you had had the surgery in the beginning, is that really a good trade-off?\u201d<\/p>\n\n\n\n<p>And the study isn\u2019t representative of all women with DCIS, Morrow says.<\/p>\n\n\n<div class=\"wp-block-image  has-alignleft\">\n<figure class=\"alignleft size-full is-resized\"><figcaption class=\"wp-element-caption\"><span class=\"caption wp-caption-3147600\">Ductal carcinoma in situ appears in this mammogram as white flecks in an area (gray) of dense breast tissue. This early or precancerous tumor, which is confined to milk ducts, is often called DCIS or Stage 0 breast cancer.<\/span><span class=\"credit wp-credit-3147600\">Duke Health<\/span><\/figcaption><\/figure><\/div>\n\n\n<p>As Hwang notes, the study examined DCIS in women age 40 and over in which abnormal duct cells \u201cdid not look particularly aggressive\u201d and that have receptors for hormones such as estrogen or progesterone. Those factors make the cells low risk for becoming invasive cancer and controllable with hormone therapy. About half of the more than 50,000 cases of DCIS diagnosed in the United States each year fall into the low-risk category, Hwang says. People with more aggressive forms of DCIS shouldn\u2019t wait to have it removed, she says.<\/p>\n\n\n\n<p>Another difference between the women who volunteered for the study and the general population diagnosed with Stage 0 breast cancer is psychological, Morrow says. Often patients diagnosed with DCIS want it removed. But \u201cwomen who went into this study very clearly wanted to have <em>no <\/em>surgery.\u201d In fact, an unexpectedly large number of the 473 women randomly assigned to get surgery refused. Only 264 went ahead with their designated treatment.<\/p>\n\n\n\n<p>Patients and patient advocates who are worried about over-treatment may be reassured by the study, Hwang says. \u201cPatients [diagnosed with DCIS] used to be told, \u2018You need to be in the operating room next week so we can get this out.\u2019 They can take a lot of reassurance in knowing that this is not an emergency, they don\u2019t have to rush into anything.\u201d<\/p>\n\n\n<aside class=\"sn-conversion rich-text rich-text--with-sidebar\">\n<p class=\"has-text-align-center wp-elements-27c40654034fbeecef6418d6adfe0794\" style=\"color:gray; margin-bottom:0px; font-size:.9rem;\">Sponsor Message<\/p>\n<!-- Tag ID: sciencenews-org_leaderboard_incontent -->\n\n<\/aside>\n\n\n<p>A companion study, published December 12 in <em>JAMA Oncology<\/em>, examined the <a href=\"https:\/\/jamanetwork.com\/journals\/jamaoncology\/article-abstract\/2828196\" target=\"_blank\" rel=\"noopener\">quality of life<\/a> for patients in the monitoring and surgery groups. \u201cPatients in the active monitoring group did not spend all their days worrying about things,\u201d Hwang says. \u201cThere was an equal amount of worry in both groups.\u201d<\/p>\n\n\n\n\n\n\n\n\t\t\t<\/div>\r\n<br>\r\n<br><a href=\"https:\/\/www.sciencenews.org\/article\/stage-0-breast-cancer-wait-surgery\">Source link <\/a>","protected":false},"excerpt":{"rendered":"<p>Watch and wait may be an alternative to surgery for some women with a very early form of breast cancer. A new study of 957 women evaluated whether it was safe to do active monitoring of a low-risk form of ductal carcinoma in situ, or DCIS \u2014 a noninvasive cancer, often called Stage 0 breast [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":199223,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","fifu_image_url":"https:\/\/i0.wp.com\/www.sciencenews.org\/wp-content\/uploads\/2024\/12\/121324_ts_breast-cancer_inline.jpg?fit=680%2C713&ssl=1","fifu_image_alt":"","footnotes":""},"categories":[606],"tags":[280,281,9164,3636,526,288],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts\/199222"}],"collection":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/comments?post=199222"}],"version-history":[{"count":1,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts\/199222\/revisions"}],"predecessor-version":[{"id":199224,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts\/199222\/revisions\/199224"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/media\/199223"}],"wp:attachment":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/media?parent=199222"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/categories?post=199222"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/tags?post=199222"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}