For Women With Early-Stage Breast Cancer, Guessing Game May Be Over

The guessing game is over.  In May researchers discovered 12 genes that, when expressed, can predict fairly accurately the chances of a recurrence for woman already diagnosed with ductal cell carcinoma (DCIS), or non-invasive breast cancer eliminating treatment that may not be necessary.

I wish this had been around when I was diagnosed with the disease.  Instead, I had radiation but was ultimately forced to have the major surgery most women dread, anyway.  I did have a recurrence, which is what led to the surgery, but  looking back, doctors think the cancer cells were there all along, just not thought to be significant.  Scary.

Had these additional cells been spotted with my first bunch of abnormal cells, I most likely would have immediately been faced with a mastectomy, but I would have avoided six weeks of radiation that can cause cancer in the future, and which pretty much ruined my reconstruction. Radiation stretches and tightens the skin and over time, flattens it.  Surgery to fix the problem is often difficult and risky because the skin is very thin, and it's often not successful.  Surgeons don't like to operate on irradiated breasts.

But now, thanks to the "DCIS Score," patients diagnosed with DCIS -- cancer that has not left the breast's milk ducts -- "have the benefit of a multi-gene analysis that considers gene patterns to individualize therapy and determine the chance for recurrence, potentially sparing the patient additional therapy," according to

Doctors are so concerned about recurrence in DCIS patients because it's fairly common -- and 50% of the time, the cancer has spread.

I was very fortunate that both times, my DCIS was non-invasive, though the first go-round was a little iffy; pathologists weren't quite sure because it was borderline, but thankfully, the non-invasive diagnosis turned out to be right.

Certain conditions are also factored in, like "age, menopause status, tumor size, margin width of the excision, tumor grade and an analysis of 21 genes, including seven genes that predict recurrence risk," before deciding on treatment now, reports.

My treatment with radiation was perfectly standard at the time. Surgery alone cures 70% of women,  but 30% will go on to have a recurrence in the same breast. That doesn't sound like much, but it is, if you're the one who has it.  Radiation was given as "insurance," and that was how it was sold to me.  I'm not completely sorry, because maybe it did prevent some recurrences before my bilateral mastectomy.  But since I ultimately had the maximum treatment, and the radiation kind of screwed everything up, I wished this test had been around nine years ago!



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