Comedian Wanda Sykes revealed that she got a double mastectomy after doctors found abnormal cells inside her breast duct. Her decision to take such an aggressive treatment is a matter of some controversy.
Sykes was diagnosed with DCIS, ductal carcinoma in situ. The controversy is because some doctors don't think it needs aggressive treatment and should just be checked on a regular basis. Other experts point out that some women -- especially those with the BRCA mutation, which may increase the risk of cancer -- may elect to have surgery.
"DCIS is basically zero-stage cancer, but cancer is cancer," said the actress.
While Sykes is correct about that, the decision about what to do is not always simple. In low-grade DCIS, there are abnormal cells inside the lining of the breast duct. But it is confined there, and in up to 80 percent of cases, may not ever cause any illness.
In the other 20-30 percent of cases, those cells can get out of the breast duct into other parts of the body.
"Well, a DCIS hasn't broken through the wall of the milk duct," said breast surgeon Deanna Attai. "It's also sometimes thought of as a curable breast cancer. The problem is though, these cells can potentially develop into invasive breast cancer. We just don't know which women will progress and which will stay at this very low-grade cancer stage."
Some women decide with their doctors to wait and see, and go in for regular checkups to monitor the cells.
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Others, such as Sykes, decide to forgo any risk and get a double mastectomy.
Though, there is still a 1-3 percent chance of the cancer returning even after the breast is removed, Attai said.
Recent studies show that, for some women, lumpectomies can lead to a cure as often as mastectomies, without as many possible complications.
In the end, it's a personal decision based on a patient's history.
Patients should consider the size of the abnormality, its location, medical history, personal factors, and seek as many opinions as necessary before making a choice about treatment.
