DCIS – What’s all the fuss about?
What is DCIS?
Ductal Carcinoma in Situ (DCIS) is a condition of abnormal cells (not cancerous) found in the lining of milk ducts of the breast, not in the surrounding tissue. Because the abnormal cells have not moved to surrounding issue, it is argued that it should be DCIS2reclassified as a ‘non-cancerous’ condition, but many conventional doctors view DCIS as ‘pre-cancerous’, arguing that because it could become invasive it should be treated as aggressively as invasive cancer.

What’s in a name? (watch this video)
Due to the non-invasive nature of DCIS, the ‘C’ for carcinoma is misleading and inaccurate. There are many calling for its reclassification, removing the word ‘Carcinoma’ as there is evidence that it makes women panic, introducing unnecessary pressure and affecting her chance of choosing the best options and appropriate treatment: “The fear attached to the word cancer leads people to overreact and makes it hard to develop more prudent and cautious approaches,” says Professor H. Gilbert Welch, Dartmouth College in New Hampshire.

How is it detected?
DCIS was rarely detected before the early 1980s. Since the introduction of routine Mammography screening, DCIS represents about 25% of all breast cancer diagnosis. Before Routine Mammography, breast cancer was discovered only if a noticeable lump appeared, or other symptoms appeared like discharge. So, in a sense Mammography is too effective in detecting DCIS (non life-threatening conditions) resulting in over diagnosis and over-treatment. Mammography is limited in the detection of breast abnormalities in younger women with dense breast tissue.

Will it develop into invasive cancer?
If DCIS is left untreated, it MAY, over a period of many years, spread into or invade the breast tissue surrounding the ducts. It would then be known as invasive breast cancer. DCIS is not harmful in itself, but it is usually treated by conventional physicians as aggressively as if it is invasive breast cancer. 40% of women diagnosed with DCIS in the UK have their whole breast removed (mastectomy). Yet this approach is being questioned as evidence emerges that for some women DCIS presents no risk at all. The concern is that the increase in routine mammography screening has detected more harmless DCIS cases, resulting in more physicians resorting to remove a lump, that if left alone would have never caused any problems.

It is broadly considered that there is no anatomical screening method that can reliably predict whether DCIS will develop into invasive cancer. However, Thermography offers a physiological view of the breast that can present the doctor with vital information about the health of the breast that could prevent unnessesary treatments.

Where does Thermography fit in?
Thermography cannot detect anatomical abnormalities, so it will not detect a DCIS. A thermogram reveals the physiology of the body and breast, showing changes at the metabolic level, revealing imbalances in entire regions of the body. A thermogram can be used in conjunction with a mammogram (after diagnosing DCIS) to consider the patient’s best treatment options, helping her decide whether she requires aggressive or conservative treatment and reducing the chances of over diagnosis. Thermography measures the amount of heat delivered to the skin by infrared radiation, this is represented by coloured patterns on the thermal image. By studying these patterns the diagnostician can see metabolic activity in the body and breast, allowing them to judge the probability of malignancies or tumours in their early development stage.

A DCIS diagnosis by routine mammography has resulted in over-diagnosis and unnecessary treatment for too many women who would otherwise continue healthy lives if left alone. The issue of informative medical practice left aside, conventional medicine cannot predict the probability of DCIS later developing into invasive cancer, but used in conjunction with Thermography, which by its nature can see physiological imbalances, women could choose the appropriate treatment and avoid unnecessary treatment. Part of this conjunctive approach would also include getting the language correct, helping women make the best choices about their treatment without panic clouding their judgement.

Picture credit: slgckcgCreative Commons license