DCIS breast cancer patients ‘overestimate risk’

Many women who are diagnosed with ductal carcinoma in situ (DCIS) overestimate their risk of recurrence or dying from the disease, often as a result of anxiety, a new study shows.

DCIS is the most common form of non-invasive breast cancer, in which cells inside some of the ducts in the breast have started to become cancerous. However, the cells have not started to spread into the surrounding breast tissue or elsewhere in the body and treatment is usually successful, with only around one per cent of patients dying from the disease.

Despite this, researchers at Dana-Farber Cancer Institute in Boston found that many patients perceive their prognosis to be significantly worse than in reality.

Martin Ledwick, manager of Cancer Research UK’s team of information nurses, said: “Although it can feel very frightening when someone is diagnosed with DCIS, treatment and follow up for it are very successful. So the risk of going on to develop an invasive breast cancer or have their life expectancy shortened by DCIS is very low.”

The researchers surveyed nearly 500 newly-diagnosed DCIS patients about their quality of life and perceived risk of disease recurrence of invasive breast cancer, publishing their findings in the Journal of the National Cancer Institute (JNCI).

At the start of the study, ten per cent of patients reported substantial anxiety and two per cent were depressed.

Fifty-four per cent of patients thought that they were at moderate risk of developing DCIS again within the next five years, and 68 per cent thought that it was moderately likely to happen again at some point during their lifetime. In addition, 28 per cent believed that it was at least moderately likely that the disease would spread to other parts of their body.

Those women with high levels of anxiety were found to be more likely to overestimate their risk of future disease.

Lead author Dr Ann Partridge, a breast oncologist at Dana-Farber, commented: “Although DCIS typically is very treatable disease, many women diagnosed with DCIS develop inaccurate risk perceptions. This exaggerated sense of risk needs to be addressed, as it may cause women to make poor treatment choices and adversely affect their emotional well-being and subsequent health behaviours.”

Dr Partridge said that some of the anxiety is linked to society’s fears about breast cancer and called for improved communication between medical professionals and patients.

“A woman may also have multiple care providers – medical oncologist, surgeon, plastic surgeon, internist – and may hear mixed messages about her risks. Improved understanding of DCIS on the part of the medical community may also help women make better, more informed decisions about their care,” she said.