More questions than answers on DCIS?

The NIH state-of-the-science conference on DCIS or ductal carcinoma in situ just concluded with a phone briefing for journalists.

Some of the points raised on the call:

• DCIS - noninvasive though it may be - is considered a risk factor for invasive cancer.
• How would the expert panel quantify that for women? They don't know.
• Communication about DCIS for women and for physicians needs to improve.
• The panel stated that the risk of DCIS in the opposite unaffected breast is low. Still, women are increasingly choosing to have the other breast removed despite the fact that "no clear data exist to suggest that this improves patient outcomes."
• It's not clear - despite what was written in the panel's original draft document - whether women are asking for this opposite-breast mastectomy, or whether physicians are recommending it.
• One panel member voiced a concern that "We're doing a significant operation for a condition for which many women would survive anyway."

This is one of biggest conundrums in medicine. It will be interesting to read the final panel document, and to see how their deliberations are communicated to patients and physicians.