Dana-Farber Aims to Reduce Overtreatment of DCIS Breast Cancer

A new study will examine whether surveillance is the best option for some patients.

For women with a certain type of breast cancer, the best treatment may be no treatment at all.

Each year, around 60,000  people in the United States are diagnosed with ductal carcinoma in situ (DCIS), a breast cancer subtype that is largely self-contained and non-invasive. Nonetheless, the current treatment for DCIS involves surgery, either a mastectomy or a lumpectomy, and is often combined with radiation therapy. But is all that necessary?

That’s what Dana-Farber Cancer Institute (DFCI) is hoping to find out in a new study. Researchers hope to determine whether certain groups of patients would benefit more from close surveillance than invasive treatments, which can come with a host of side effects and potentially few advantages for patients with DCIS. The study is supported by a $13.3 million grant from the Patient-Centered Outcomes Research Institute (PCORI), as it aims to help patients consider a variety of treatment options for DCIS.

“The majority of women diagnosed with DCIS will not develop invasive cancer, meaning that many women are currently being treated with minimal to no potential benefits,” said Ann Partridge, a senior physician at DCFI and the study’s co-principal investigator, in a statement.

The patients in the study will choose between the more conservative surveillance approach and standard treatment, and those in close surveillance will receive surgery or radiation only upon disease progression. Both groups will also have the option to undergo endocrine therapy, which helps block hormones that can lead to some breast tumors. Researchers will then determine whether aggressive treatment or surveillance seems to be the best option for DCIS patients.

“Our study will evaluate disease and quality of life outcomes among women with newly diagnosed, low-risk DCIS who undergo active surveillance (i.e., careful follow-up for changes in the breast), compared to women who undergo standard treatment,” Partridge said in the statement.