Specialists at Baptist Health in Boca Raton say some women with low-risk ductal carcinoma in situ, known as stage 0 breast cancer, may be able to delay surgery safely through close medical monitoring. The guidance was published Nov. 6 by the Boca Raton Tribune.
DCIS involves abnormal cells inside the milk ducts that have not spread into surrounding tissue. Doctors cannot always tell which cases will become invasive, so the condition has long been treated the same way for nearly everyone, usually with surgery and sometimes radiation or hormone-blocking medication. Dr. Anastasia Tousimis, a breast surgical oncologist and chief of breast surgery at Baptist Health, said research shows that some low-risk cases do not progress.
Active monitoring relies on regular breast imaging, with mammograms typically every six months. Doctors weigh a patient’s age, the size and location of the abnormal cells, hormone-receptor status and how the cells look under a microscope. Patients with larger areas of DCIS or several affected sites are usually not good candidates.
If imaging shows new or increasing microcalcifications or a suspicious mass, doctors would likely order more tests, a biopsy or surgery. Dr. Gladys Giron of the Herbert Wertheim Cancer Institute said surveillance requires a commitment to follow-up appointments.
Radiation after surgery is also under review. Dr. Youssef Zeidan, a radiation oncologist at the Lynn Cancer Institute at Boca Raton Regional Hospital, said early randomized trial results point to a subgroup that might qualify for monitoring, but follow-up is still short. Baptist Health Cancer Care is expected to join a trial of the DCISionRT test, which analyzes biological traits to guide radiation decisions.
Specialists stress that monitoring remains under investigation and is not a replacement for surgery for most patients. Women considering their options are encouraged to consult a multidisciplinary team.
“
